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World Changer Award Nomination Form
Questions? Contact us: Awards@seniainternational.org
SENIA World Changer Award Digital App - Full
Section 1. - General Information
General Information
Full Name of Nominator
*
First Middle Last Name (e.g. - John B. Goode)
E-mail Address of Nominator
*
Full Name of Nominee
*
First Middle Last Name (e.g. - John B. Goode)
E-mail Address of Nominee
*
School/Organization of Nominee
Location of Nominee
*
Example - South Africa
Nationality of Nominee
*
Example - South African
Nominee Photo
*
Drop a file here or click to upload
Choose File
Maximum upload size: 516MB
Upload one photo of the applicant here.
Section 2. - Nomination Prompts
Nomination Response Prompts
A. Nomination Response
*
In 150 words or less respond to the following question - What inspires this person or organization to promote inclusion in your community?
B. Nomination Video
Please type a link to a video (videos no longer than 2 minutes) that demonstrates how the individual you are nominating is a World Changer.
Section 3. - Confirmation
Confirmation
Once submitted I agree that all materials are property of SENIA international and can be used or distributed for marketing and promotional purposes.
*
Agree
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