Industry_Day_-_Registration_Form.docx

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Attached to
USAID Pakistan Industry Day-Request for Information
Solicitation number
RFI-391-19-INDUSTRYDAY
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The purpose of this amendment is to post/upload Word Version of Industry Day Registration Form.

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USAID/Pakistan - Industry Day

REGISTRATION FORM

1. Name of Organization:

2. Office Address:

3. City:
4. Province/Postal Code:
5. Telephone Number:
6. E-mail Address:

Website address (if any):

7. Contact Person (Name)::Contact Number:
Title:E-mail Address:

8. Market Area (Geographical) Covered by the Firm: (Select where the firm currently has head/ branch office or project based office)

Khyber Pakhtunkhwa (KP) FATA Baluchistan Any Other ________________

9. Expertise in the field of:

Health Education Agriculture

Energy Economic Growth Stabilization and Governance

Any Other (Specify)_________________________

10. Last five (05) ongoing / completed Projects in KP/FATA and Baluchistan (if any):

S. No
Name/Title of Project
No of Employees
Location
Period of Project
Project Value (PKR / USD)
Donor/Source of Funding

11. Registration with Pakistani Government Entity

YES NO

If the answer is YES, please provide the following additional information

13. Are you willing to bear the cost associated with travel/accommodation to attend Industry Day in Islamabad?

YES NO

11.a. Name of Federal Entity:

14.If you have any questions for USAID/Pakistan to address in the Industry Day, please list down.

11.b. Name of Provincial Entity:

11.c. Date of Registration:

11.d. Organizational Status (For Profit/Not for Profit):

12. No. of current full time Employees:__________ image1.png image2.png

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