CII Start Ups Mission to Russia

09 December – 15 December 2018: Russia

Reply to (on or before 28 Nov, 2018):

Mr Priyanka Mukhija
Confederation of Indian Industry Please share
249-F, Udyog Vihar a
Phase-IV, Sector-18 Photo (high
Gurgaon-122 015 (Haryana) resolution
Email: priyanka.mukhija@cii.in photo)

1 Name

Designation

Date of Birth
2 Company Name &
Address:

Secretary’s Name

Telephone: Fax:

Mobile Telephone:

Email:

Residential Address
& Telephone number:

3 Passport Details
Passport No. Date of Issue:

Place of Issue: Validity:

Details
Are you a Start-up (Yes/ No) -

If yes, Date of Incorporation- (Kindly

share the soft copy of the registration
Certificate)

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 CII Start Ups Mission to Russia
09 December – 15 December 2018: Russia
REGISTRATION FEES:

To cover administrative costs we are charging a nominal fee of Rs. 35,000/- (exclusive
of taxes) from every mission member. Total fees – Rs 41,300/-.

The payment may be made by Cheque/Demand Draft in favour of “Confederation of

Indian Industry” - payable at New Delhi.
Cheque/Draft No: _________Drawn on __________ Date ___________

 Details for Mission brochure

For the Mission brochure, please attach your brief bio-data and the company profile
(should not exceed 150 words) in a descriptive format given below:

Personal Profile:
(150 Words)

Company Profile:

(200 Word)

Specific Interest in the Country:

Any Issues/Concerns:

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 CII Start Ups Mission to Russia
09 December – 15 December 2018: Russia

Miscellaneous Information

 All mission members are requested to adhere to the schedule of timings and
meetings
 A member is requested to attend all mission programs / events
 The suggested dress code is formal, unless mentioned otherwise

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