Consultant Survey
Thank you for showing interest in becoming part of our Nation Builder Community.

Please provide the information requested below, to assist us in getting to know you and ensure that we keep our products and events current. All information provided will be treated as confidential and will not be shared with third parties.

Protection of Personal Information Act of 2013 (“POPI”) 

We are committed to protecting your privacy. Whenever you use our website, complete an application form or contact us electronically, you consent to our processing of your personal information in accordance with the requirements of POPI. In the event that you wish to revoke your consent, please send an email to popia@mergon.co.za. 

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Email *
First Name: *
Last Name: *
Organisation Name: *
Where are you located? *
Where did you hear about Nation Builder? *
Required
Which Nation Builder offerings have you interacted with previously? *
Please select all applicable options.
Required
Which of the Nation Builder offerings listed below, would be of interest to you?
Please select all applicable options.
What is the annual turnover of your company? *
What is the approximate annual social investment spend that you oversee for your clients? (if not applicable please indicate N/A) *
What type of social impact resources would you find useful? *
What are some topics of conversation that you'd like to engage in with peers? *
Thank you!
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