‘Stand Up’ Return Form - Submit before 12pm 16th October

 

After completing your Stand Up event/moment send in the following ‘Return Form’.

This form must be sent in before 12pm on 16th October to be counted for the World Record.

Alternatively you may download the form here and email it to standup@makepovertyhistory.ae

Pre-Registration of your stand up event is NOT required. You can qualify for the world record by simply submitting this form after your event

Personnal/Contact Details

All sections in RED are compulsory.

First name: 
Last name:
School/Company:

Gender:
Male
Female

Po Box:
Address 1:
Address 2:

City:
Abu Dhabi
Dubai
Sharjah
Ajman
Umm Al Qwain
Ras Al Khaima
Al Ain
Other

 Country:
 United Arab Emirates 
 

Email Address: 
Telephone: 
Mobile: 050

Event Details

Location of ‘Stand Up’ Event: 
Date of ‘Stand Up’ Event: 
Time of ‘Stand Up’ Event:

Tell us about your event:

Number of people at the event: 

 I confirm that the above information is accurate to the best of my knowledge

Signature
Full Name: Initials:  

Filling this form up and clicking submit automatically sends these details to MPH alternatively you could download the Return form, fill it out and email it to standup@makepovertyhistory.ae