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PERSONAL INFORMATION
Full Name
*
School Name
*
City
*
Designation
*
Email
*
Phone No.
*
EDUCATION LEADERS OF INDIA INFORMATION
What offering(s) of ELI interests you the most?
*
Professional Conferences
Referral Program
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EdTalk
Choose how you would prefer to be involved in ELI EdTalk
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Audience
Both
What topics would interest you?
*
Curriculum & Pedagogy
Teacher Development
School Improvement
Online vs. Offline Learning
Educational Technology
Others
Other
*
Contact Person
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*
City
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Contact Number
*
Email
*
School 1
School 2
Name of the Principal
*
Name of the Principal
Name of the School
*
Name of the School
City
*
City
Reference Phone Number
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Reference Phone Number
Name
*
School Name
*
Phone
*
Email
*
Name
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First Name
Last Name
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Email
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