CAMPAIGN LEADER sign-up

Thank you for taking out time wanting to understand the #BrickByBrick campaign and considering to help us raise the required funds for the construction of "India's First Wheelchair Tennis Centre"

Request you to kindly help us with the following information / data to help us create your personal campaign Page.

Full Name

First Name

Last Name

Name you would like to be called

We would like to use this name in our social media creatives, informal communications etc

Email address

Whatsapp Number / mobile number

Instagram

@

Twitter

@

Your message / pitch to your family, friends and collogues - Why do you think people must contribute to this project

You are leading this campaign in

Individual

On behalf of my Organization

if you like, we will be happy to create the poster with your pic in it. Pls let us know how you would like it

Yes

May be

No

How many bricks would like to put your efforts for ?

With every brick you are helping us raise 250Rs

Would you like to participate in the LUCKY LEADER Contest?

What does the LUCKY LEADER WIN By helping the project with 40 Bricks, the Leader has an option to participate in a Lucky Draw, if he/she chooses, that can win gifts worth Rs25000 (this gift will be as per the choice of the LUCKY LEADER - yes, you heard it right - The Lucky Leader gets to choose her/his gift worth Rs25000).

Yes

No

I want to help this campaign as

OPPORTUNITY FOR PROFESSIONALS / SOCIAL MEDIA INFLUENCERS In case you want to take up being Campaign Leader on a professional basis you are welcome to do the same. You will be remunerated for your efforts in the campaign, based on your performance outcome. In addition to the opportunity of being part of team creating history in the sporting world you will be Paid 5 % of the fund raised as your remuneration.

Volunteer Influencer

Professional / Performance Based