Name*: Last Name*:
Organization*: Designation*:
City: State:
Mobile No: * Pin/Zip Code*:
E-mail*: Phone*:
Website*: Business Interest*:

A) * How did you learn about RenewX 2018?

(Please specify)

B) * What is your organization’s profile?

(Please specify)

C) * What is the objective of your participation?

D) * Are you involved in purchasing / recommending?

E) * What is your organization’s main activity?

(please specify)