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(You can apply for yourself or someone else)

Your first name:

Your last name:

Your email:

Code

Your phone number:

Your address:

I am nominating:

How did you hear about us?

Tell us the story of the nomiated person and why they should be chosen (the more detail, the better!)

What does the nomiated person need? (Funds, guidance, support, please be as specific as possible)

Which race or ethnicity best describes the nominated person?

Which gender best describes the nominated person?

Which Travlward value doe the nominated person live by * Required

Wellbeing

Creation

Education

Integrity

Diversity

Service

Which category best describes the nominee's age? * Required

17 or younger

18-20

21-29

30-39

40-49

50-59

60-69

70-79

80+

In which country does the nominated person live? *

I accept terms & conditions

Thank you for applying. We will be in touch with you if you are selected!

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