Global reputation Nomination form - Reputation Poll Intl

Global Reputation

Full Name of Nominee:

First

Last

Nationality / Country of Origin

Current Residence (City, Country)

Profession / Primary Field of Impact

Organization / Institution / Affiliation (if any)

Other (Specify)

Active Social Media Profiles

Link to the nominee’s official website or active social media profiles

Why are you Nominating this Person?

How has the nominee contributed to Africa’s reputation globally?

What values best describe this nominee?

Notable Achievements / Recognitions:

Your Full Name

Email Address

Country

Relationship to Nominee

Why do you believe this nominee deserves to be listed among the 100 Most Reputable Africans?

Other (specify)

I confirm that all information provided is accurate to the best of my knowledge.
I understand that submission of this form does not guarantee selection.
I consent to Reputation Poll International contacting me for further information if required.