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FIAPO Bootcamp 2017 Registration Form


Do Not Use Single Quotes In Any Of The Fields Below Or Your Data Will Not Be Recorded

Note: If you're paying for the bootcamp by means other than ccavenue, please send us an email at koushik@fiapo.org mentioning that the money transferred is for the bootcamp.

Cancellation / No Show Policy: Please note that ALL cancellations less than 15 working days prior to the event will be charged the full amount. Any delegates that do not show up on the day will also be charged this rate. Any name changes to be advised

Registration for Regional Bootcamp

 
Delegate's Name *
Organisation's Name(if applicable)
Position
Address *
Please describe your current activism and How long have you been doing it for?*
Gender*
Email*
Pan Id*
Website
Telephone*
Choose a track:*
The contribution you make includes your access to three days of workshops, accommodation, all meals from lunch on Friday to evening tea on Sunday. Scholarships are available, preference given to students and those not currently in employment. But we do not want cost to be a barrier, so contact us at koushik@fiapo.org to seek financial aid if you need it.
Early Bird Discount will end on 16th October. Payment Options:*
Single Sharing Rs. 4000
Double Sharing Rs. 2000
Triple Sharing Rs. 1000
Payment Info: On completion of your registration, you will be given a unique token number. Please make payment quoting the token number. Registration is not confirmed until payment is recieved. Payment should be made within 3 days by online transfer or cheque, or this registration will be discarded. Account details available here

Overseas transfers are not to be made through this account. Anyone who wants to make an overseas transfer should contact mail@fiapo.org

Any other requirements

 
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