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Your First Name*

Your Last Name*

Your Title*

Your Company*

Your Email*

Your Phone*

Your Country*

Tell us about the person you are nominating...

Is the nominee 35 years old or younger?*

Reference Name:

Reference Email:

Nominee First Name*

Nominee Last Name*

Nominee Title*

Nominee Company*

Nominee Email*

Nominee Phone*

Describe the nominee's specific achievements (500 words or less)*

How long has the nominee been working in the communications technology industry?*

Is the nominee part of any industry associations?*

If yes, which ones?

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