AFI Forum 2018: Influencer Interest Form
***Interest Form for Influencers***

The 7th AFI Annual Forum, the annual flagship event of Action For India, will bring together 100 leading social entrepreneurs and 100 "influencers" (donors, investors, IAS officers, technology executives, policy analysts, etc...), for a two-day immersive experience at the magical IMAGINARIUM in Alibaug (near Mumbai) on 4th & 5th OCTOBER, 2018. This year, the event is being organized in collaboration with LetsEndorse.

We are extending an exclusive invitation for you to submit your interest and indicate your availability to join as one of the100 influencers and engage yourself in conversations, discussions, deliberations & networking opportunities with the 100 leading social entrepreneurs of India.

Please confirm your interest to be an Influencer by sharing your details below. This will help us make the Forum and interactions thereof fruitful for all.

First Name *
Your answer
Last Name *
Your answer
Organization *
Your answer
Designation *
Your answer
Email address *
Your answer
Contact Number *
Please provide mobile numbers as it will greatly help in logistics and during emergencies
Your answer
Have you worked with social entrepreneurs before? *
What is your area of expertise? Please indicate those where you could provide assistance to Social Entrepreneurs. *
If you chose "Other," please provide specific details
Required
Which 'Influencer category' would you associate yourself with? *
Please share a brief bio of yours in less than 100 words *
This bio may go on our event booklet.
Your answer
Please share the link to your LinkedIn profile *
Your answer
Please share your Twitter handle *
Your answer
Please indicate any other website link where we can learn more about you
Your answer
I would be attending the 7th Annual AFI Forum 2018 on: *
City travelling from *
Your answer
We would appreciate your help in our outreach to other compelling influencers to our Forum. Please recommend up to 3 influencers from your network with whom we could share about the Forum. Please include their names, organizations, location, e-mail IDs and phone numbers. *
Your answer
Please suggest Keynote Speakers whom you would like to listen to at the AFI Forum 2018
Past Keynote Speakers at AFI Annual Forums have included distinguished business, technology and government leaders such as Amitabh Kant, Desh Deshpande, Nandan & Rohini Nilekani, Ronnie Screwvala, R Chandrashekhar, and Ashish Dhawan among other eminent thought leaders.
Your answer
Have you attended an Action For India Forum before? *
If you answered "Yes" to the previous question, which year did you attend the AFI Forum?
Would you be interested in engaging with AFI & the social entrepreneurs you meet, beyond the Forum? *
Which other social impact conference(s) that you have attended has made an impression on you and what did you most like about it?
Your answer
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