Author: Chengetai Masango

MAG Nomination Submission Template:
Please submit this form in .doc or .rtf format.
 
Title ( Ms. / Mr. ): | Surname:
First name: | Other names:
Job Title(s) |
Organization(s): |
City of Residence: | Country of Residence:
Nationality(ies): | Stakeholder Group( Civil Society, Government, Media,Technical Community, Private Sector)
Contact Email: | Contact Telephone ( Please indicate the country code) :
Brief relevant descriptive biography of not more than 300 words |
Nominated by: | Name of nominee's organization (If on behalf of an organization)
Nominator's Contact email : | Nominator' Contact Telephone: