KIC Participation Form
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Startup Company Name *
Brand Name *
Website of Company *
CIN No. (Registration No.) *
DPIIT No. (Startup India Recognization)     *
PAN *
GST No. (Optional)    
Stage of Startup     *
Current Turnover (Last Three Month) *
CEO/SPOC Name *
SPOC Contact No. *
SPOC E-Mail Id *

Team Details 
Founder Name
*
PAN 
*
DIN
*

Contact No.
*

E-Mail Id
*
Equity / ESOP Share %
*
Equity / ESOP Share %
*
Primary Investment  
*
Co-Founder Name
*
PAN 
*
DIN
*

Contact No.
*

E-Mail Id
*
Equity / ESOP Share %
*
Primary Investment  
*
  Director Name
*
PAN 
*
DIN
*

Contact No.
*

E-Mail Id
*
Equity / ESOP Share %
*
Primary Investment  
*
Product/Service Description

*
Allocated Stall No.

*
Branding Material Available

*
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