Application Form

Lucknow | Campus Ambassador Program

Name * First Last
DOB * / MM / DD YYYY
Institution Name *
Course/Class *
Residence Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone *
Email *
What are your preferred areas of work? (minimum two options) * Social Issues Culture Cuisine Literature Monuments Photography/Videography Event Management Social Media Management Other
Career Plans:
Facebook I'd *

eg: https://facebook.com/XYZ
Instagram I'd *

eg: https://instagram.com/XYZ
* I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief.