Please be sure to fill in all the information below. The fields marked with an asterisk (*) are required.
When ready to submit, press the "submit" button at the end of the form. After submitting please wait until the "submission successful" confirmation is displayed.
After doing so, please send a separate e-mail to
c/c firstname.lastname@example.org confirming that you have submitted a nomination through the website.
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The photograph can be in TIFF, EPS, JPEG or BPM format and the maximum file size is 10MB.
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