AFRICAN GOODWILL AWARDS NOMINATION

AFRICAN GOODWILL AWARDS NOMINATION FORM

(Please complete one form for each nomination category, if you have question, please call 310.676.7300)

Please email your application to goodwillawards@gmail.com or mail to African Focus Inc. P.O. BOX 11091 Carson, CA 90749

For more information, please visit our website: www.africanfocus.org, also visit our past event photo gallery at www.africangoodwillawardsandinduction.com

I ________________________________would like to nominate the following person(s) or groups, Company to be considered for the award category below:

NAME OF THE NOMINEE

ADDRESS:

PHONE NUMBER

(###)

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CONTACT PERSON

Please write on a separate page the basis of your recommendation.

NAME OF THE CORPORATION OR ORGANIZATION

ADDRESS:

PHONE NUMBER

(###)

###

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CONTACT PERSON

Section 2

Please write on a separate page the basis of your recommendation.

9. Signature of Content and Submittal Agreement

Applicants, by signing below affirm that the information provided in this application is true and agree that any false information provided in any part of this application shall constitute a reason for denial of your application .

Applicant signature: ____________________________ Date: _________________ Electronic signature accepted