Name of the Team* (required)
Team Leader Name* (required)
Primary E-mail for Communication* (required)
Primary Mobile for Communication* (required)
Description of Idea* (required)
Team Member 1 Details:
Name* (required)
E-mail* (required)
Mobile*
College/Institution Name*
Currently Enrolled*: ---YesNo
Program Name*
Year of Enrollment* ---1st Year2nd Year3rd Year4th YearFinal Year
Team Member 2 Details:
Name
E-mail
Mobile
College/Institution Name
Currently Enrolled: ---YesNo
Program Name
Year of Enrollment ---1st Year2nd Year3rd Year4th YearFinal Year
Team Member 3 Details:
Declarations*: 1. I/We are the intellectual owners of the plan or must have a letter from the intellectual owner(s) consenting for the exploitation of the plan* ---YesNo
2. This idea has been recognized as a winner at another BPC* ---YesNo
3. If the plan is selected as a Top Finalist, select members of the team (as listed above) will travel to FIIB to present to the Judging Panel* ---YesNo
4. If the plan is adjudged to be a winner, the prize money will be remitted by cheque. The name of the person/company on the cheque should be:
Form Filled by*
Your E-mail id*
Your Mobile Number*
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