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		I would like to sign up as a coach for India Venture 2000. I understand each team would require 2-3 hours of my time per week. I would like to coach 1 2 3 Team(s)
	OR
		I am interested but I need more information about
		I am willing to sign a confidentiality agreement
	My Details (None of these details will be made avaliable to participants without your express consent)
	Title	Mr Ms
	Surname *
	Name *
	Education
		Graduation
	Year * University/ Institution *
		Post-graduation
	Year University/ Institution
	Company *
	Function
	Designation*
	Address
	City *
	Tel. No.	(Off.)   (Res.)
	e-mail *
	My References (Min. 2 ref's.)
	At IT/e-commerce
	Reference1*
	Tel. No. *	(Off.)   (Res.)
	e-mail *
	Reference2*
	Tel. No. *	(Off.)   (Res.)
	e-mail *
	At McKinsey
	Reference 1
	Tel. No.	(Off.)   (Res.)
	e-mail
	Reference 2
	Tel. No.	(Off.)   (Res.)
	e-mail
	My Current Profile (Please select any one profile from Entrepreneur, Professional, Employee, Academic Institute or Other)
		Entrepreneur (own business)
		Company Name
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		Web site
		Details Select a Company IT company ----------------------------------------------------------- e-commerce (Web site development) Other e-commerce services e-commerce (portal/services site) Other (please specify)
		Professional
		Select a Profession Chartered Accountant / ICWA Consultant Lawyer Venture Capitalist
		Employee in
		IT company e-commerce company Non-IT company
		As an employee, my functions are (Please select one of the following)
		Advertising / Media Business Planning /      Development Finance / Banking /      Investment banking Human resource Legal Marketing Market research Product development Technology support
		Academic Institute
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	My Previous Experience
Company 1
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Year
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Company 2
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Company 3
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