Application for Platinum
If you are interested in our Platinum ticket for our event Designing Your Future Self for 2021 and Beyond, kindly fill up this application form.

Event: Designing Your Future Self for 2021 and Beyond
Date: 28 November 2020
Time: 2pm - 7pm

Upon receiving your application, we will contact you for a 45 minutes scheduled call.
Only fill in this application form if you can commit to make payment if you are selected for this Platinum Ticket as we have limited seats for this ticket.

Thank you.

To your success,
Debugging Minds
Email address *
Name *
Current City & Country *
Phone Number *
Please enter your phone number in the following format: +6011-12345678
To qualify for Platinum ticket, we will have to schedule a 45 minutes call with you. When you be the best time to contact you? *
Please select the best time. However, we will be confirming your scheduled call via email.
Please check the following box to ensure you understand your application. *
Required
A copy of your responses will be emailed to the address you provided.
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