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IIMA Online Media Contact Management System


Full Name* :
  
Designation* :
  
Organization / Media House* :
  
Email address* :  
For every unique,valid E-mail ID only one registration is allowed
  
Confirm email address* :
  
Additional Emails:
  
Name of Bureau chief / Editor:       Email
  
Media Type / Language* :
                    
  
Office Address * :    City * :
  
State * :
  
Country * :
  
Mobile * :
  
Upload Press / Visiting Card : (Only PDF/JPG)
  
Upload Photograph : (Only JPG/GIF)
  

* Mandatory fields