25 Senior Global Leaders Nomination Form
Name of the Senior Leader you are nominating? *
First and last name
Your answer
Can you confirm the Senior Leader is over the age of 60? *
The 25 Senior Global Leaders must be over the age of 60. To the best of your knowledge, does the Senior Leader you are nominating match this description?
Required
City of their location *
Your answer
Country of their location *
Your answer
Their nationality *
Your answer
Their gender *
THEIR CONTACT DETAIL
Twitter, Sina Weibo, VKontakte, Facebook and other social media profile URL are optional.
Email *
Your answer
Contact Number *
Your answer
Twitter URL
Your answer
Facebook URL
Your answer
Sina Weibo URL
Your answer
VKontakte URL
Your answer
Other Social Media URL
Your answer
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