1. Your Name :

2. Your Email:

3. Contact Number :

4. City :

5. State :

6. Linked-in URL :

7. Organization Name :

8. Organization URL, if any :

9. Organization Type :

10. Mandatory Arrangements to be taken up by Host Partner :
Chairs/Tables for everyone (approx 100 people)Wifi (at least 100 Mbps)Projector/ScreenMicrophone/PA SystemPower Strips/OutletsWhiteboardsSound SystemMinimum 3 mikes (including 1 cordless)PodiumBackdrop arrangementVolunteers (minimum 6)

11. Will you provide refreshments for panelists and members?
---YesNo

12. Will you Honour Judges with Souvenir?
---YesNo

13. Will you Arrange Professional Photographer and Videographer?
---YesNo

14. Will You extend the outreach in your city and in your local network?
---YesNo

15. Will you provide a Local Media arrangement to cover the event?
---YesNo

16. Are you Authorized to approve for the event space & resources at your organization? If No, Mention the Name, Designation, Contact, Email Id of the authorized person.

17. List Previous major Events Hosted by the Organization. ( Give links to view ):

18. What Convinced you to apply for Hosting W-Pitch? Did someone encourage you to apply?

19. Upload your Organization Logo :

20. Upload the Event Space Pictures :

21. Anything else you’d like to say to us?

I hereby declare the information provided by me is correct to the best of my knowledge and I am aware that in case of any wrong and incorrect information my application is liable to be rejected.