Nomination Form: 50 Male Advocates for Equality in Marketing & Media
If have any questions or need help with the nomination form for the #DIMA50 Male Advocates for Equality in Marketing & Media feel free to contact Azadeh on azadeh@lync.events

Remember the closing date for entries is strictly Wednesday, 20th June, 2018.

Email address *
Nominee Full Name *
Your answer
Nominee's Job Title *
Your answer
Nominee's Company Name *
Your answer
A brief paragraph about why you think the nominee should be included in the list including brief details of their achievements *
Your answer
Nominee's Biography *
Your answer
Nominee's Headshot (please either provide a link here or email their headshot to us on clara@lync.events with their name in the subject of your email)
Your answer
Nominee's Twitter Profile
Your answer
Nominee's LinkedIn Profile
Your answer
Nominee Email (we invite all nominees to attend the event. Please add nominee's email below) *
Your answer
Your Name *
Your answer
Your Email *
Your answer
Your Job Title *
Your answer
Your Company Name *
Your answer
Your Phone number
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Lync Media Group Ltd.. Report Abuse - Terms of Service