Nomination form

Nomination Category(Required)

Nomination(Required)

Self nomination

Third-Party Nomination

Nomination Type(Required)

Individual

Company/firm/organization/instutition

Other

Details of the Nominee

Name of Nominee(Required)

First Last

Name of Organisation(Required)

If individual, indicate affiliate organization:

Title of Nominee(Required)

Job Title(Required)

Country(Required)

Email Address(Required)

Enter Email Confirm Email

Phone Number(Required)

Website(Required)

Or Social media link

Details of the Nominator

Name of Nominator(Required)

First Last

Name of Organisation(Required)

If individual, indicate affiliate organization:

Title of Nominee(Required)

Email Address(Required)

Enter Email Confirm Email

Phone Number(Required)

Relationship to the Nominee(Required)

Please describe your relationship with the nominee

Nomination Statement (Max 200 Words)(Required)

In a brief summary, show why the nominee deserves the award highlighting at least three achievements relevant to the selected category. Show their work's measurable economic, social, or policy impact in Africa. Include Eligibility, Nominee's Alignment with All African IP Summit objectives. Include Supporting evidence (provide links), and IP Leadership.

Reference

Provide at least one other reference who can attest to the nominee's eligibility for the award.

Name of Reference(Required)

First Last

Email Address(Required)

Enter Email Confirm Email

Declaration(Required)

I hereby confirm, to the best of my knowledge, that the information provided in this nomination and the supporting evidence provided is authentic, accurate and I have the necessary permission to submit any confidential or personal information included in this nomination. I understand that the Awards Committee may verify the information provided and may contact the nominee, referees, or other relevant parties.

Nomination Form

Details of the Nominee

Details of the Nominator

Reference

Useful Links

Additional Links

Contacts