Client Confirmation & Consent Form

Your Full Name *Please mention your name with prefix like Dr., Sir, Prof., etc. This name would be used as it is all throughout the magazine creation including your featured profile in the magazine, Passion Vista website, social media posts, certificate, trophy and any other document pertaining to you

Phone Number *

Email ID *

DOB

Your Organization *

Year of Establishment

Your Designation *

City *

State/Province *

Country *

Name of Your Passion Vista Relationship Manager *

Passion Vista Special Edition, you have opted for

Date of Submission:

Your complete Postal Address for shipment

(This address will be used for any print correspondence with you and/or your team including shipment of your magazines, certificate and trophy)

Office/ Apartment No. with Building Name

Street Address with Area Name and Nearest Landmark

City/ Town

State / Province

PIN Code

Country Name

Your social media handles will be tagged for all promotional activities. If you don’t have a social media handle, please mention NA against it which would also mean that you don’t want social media promotion in that social media platform.

Website *

Your LinkedIn ID *

Facebook URL *

Instagram ID *

Name of Contact Person (CP) (in case all further processes would be handled by your appointed assistant)

CP Designation

CP Mobile Number

CP Email

I uderstand that I have to submit the following within 10 days of submitting the consent form.

Duly filled Questionnaire form for 2 page profile.
One High Resolution Photograph for the Cover Design and 5 to 6 Photographs for the inside story
Video Byte for the project unveiling

Client Confirmation & Consent Form

Your complete Postal Address for shipment

(This address will be used for any print correspondence with you and/or your team including shipment of your magazines, certificate and trophy)

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