TOP 40 UNDER 40 MEN 2015 NOMINATION FORM

1. Name of nominee *

2. Telephone *

3. Email Address *

4. Date and year of birth (must provide) *

5. Sector of work *

Corporate executive
Professional services (account, lawyer, engineer, musician etc)
Entrepreneurs
Public sector

6. Name of the Organization for which the nominee works *

7. Position within the organization *

8. What is the scale of the organization's operations?

Kenya only
East Africa (two or more countries)
Multinational (operations across Africa/the world)

Number of employees

9. How big is the size of operation the nominee heads? *

Territory (choices as above in question 6)

Number of people reporting to the nominee

10. What in your view qualifies the nominee as a Top 40 under 40 man personality in Kenya? *

11. What is the nominee's most outstanding achievement to date in his selected field? *

12. What is the nominee's most outstanding achievement in his current position? *

13. Is the nominee engaged in any significant community activities in his personal capacity? *

Yes
No

Specify which ones

14. Has the nominee appeared in a previous Top 40 under 40 list? *

Yes
No

15. How is the nominee known to you? *

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