Nominate to be part of the Global Business of Data Advisory Board

Nominate yourself to be within the Global Business of Data Advisory Board.

This nomination form will take approximately 10 minutes to complete. Please answer as fully as you can. Any questions about the nomination process please email: catherine.king@coriniumgroup.com

Basic Information - In this section please submit your details.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your current job title?

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* 4. What is the name of the organization/company you work for?

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* 5. What Industry do you work in?

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* 6. What is your work email address?

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* 7. Which region are you based?

Africa

Asia

Europe

Middle East

The Americas

Oceania

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* 8. Please state the City & Country

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* 9. Please include a link to your LinkedIn profile:

Nomination Information - In this section please submit the details of why you are making the nomination.

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* 10. What are your passions within the Data, Analytics, Digital and Technology space?

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* 11. Why do you want to get involved in the Global Business of Data Advisory Board?

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* 12. Please attach any relevant documents to support your nomination. For example, articles/reports where you have contributed.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 13. Please upload a professional headshot that you'd like us to use if your nomination is successful. (Please ensure it is high quality and in color)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 14. Please provide a professional bio that you'd like us to use if your nomination is successful.

Diversity & Inclusion - The sole purpose of this section is for equality and diversity assurance. You may skip this section if you wish.

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* 15. What age category are you?

Under 25

26-35

36-45

46-55

56-65

65+

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* 16. What best describes your gender:

Female

Male

Prefer not to say

Prefer to self-describe:

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* 17. What is your sexual orientation:

Heterosexual / Straight

Gay Man

Gay Woman / Lesbian

Prefer not to say

Prefer to self-describe:

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* 18. Please state your ethnicity (or skip to the next question):

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* 19. Please state your religion (if applicable, or skip to the next question):

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* 20. Do you consider yourself to have a disability (or skip to the next question)?

Community Information

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* 21. If you're not already, would you like to subscribe to the Business of Data for exclusive reports, articles, video content, and more?

Yes

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* 22. Would you like to find out more about Data & Analytics events taking place in your region?

Yes