TED-Ed Application Form

Step 1 of 2

Start Date(Required)

Member Id

Plan(Required)

Ted-Ed Student Talks

SYM Lanes

Location(Required)

Naperville, IL, USA

Mumbai, MH, India

Akure, NG

Applicant Name(Required)

First Last

Phone(Required)

Email(Required)

Selected Theme(Required)

Date of Birth(Required)

Guidance from TED

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By submitting this form, I confirm that I agree to the terms and conditions of TED-Ed Student Talks Program and the Plastikeers Gavel Club program for use of all media related to meetings organized by these organization. We consent to our child being recorded on visual and audio media and the use of this media for the purposes of the programs.

Fathers Name(Required)

Mothers Name(Required)

Parent Phone(Required)

Parent Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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