Nominations for action/2015 Reference Group
One of our colleagues from the action/2015 Reference Group has had to step down and we now have an opening for nominations for a woman, representative for Sub-Saharan Africa.

Please submit your nomination by 17 April 2015.
Sign in to Google to save your progress. Learn more
Name of Nominee *
Title *
Organisation *
Address *
Country *
Telephone number *
including international country code
Fax number
including international country code
Email address *
Alternative email address
assistant or colleague
Gender *
* Note: This position is only opened for women from Sub-Saharan Africa, due to the specific resignation of the woman representative from the region. All other positions are still held by the regional representatives that were elected by the action/2015 coalition in July 2014.
Region Nominating For *
Note: This position is only opened for women from Sub-Saharan Africa, due to the specific resignation of the woman representative from the region. All other positions are still held by the regional representatives that were elected by the action/2015 coalition in July 2014.
Please insert a brief description of the nominee/yourself that will be used for distribution to campaign participants in the region for the upcoming election. *
Please email a photo of the nominee/yourself for the distribution to campaign participants in the region for the upcoming election (preferably .jpeg format). The name of the file should contain the name of the nominee. Emails should be sent to info@action2015.org.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy