Submit Laureate Information - Business Laureates of BC

Laureate Information

Please use this form to send us your information so we can prepare for your laureate announcement.

If you have any questions, please contact:

Delreen Motiwalla,
Director, Corporate Development & Business Laureates Hall of Fame Program
604-363-4128 or
d.motiwalla@nulljabc.org

Salutation*

e.g. Mr., Ms., Mrs., Dr., etc.

Name*

First Last

Designation(s)

e.g. O.C., O.B.C., LL.D., etc.

Job Title*

Affiliation/Company*

Email*

Phone*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Please share a short bio for our marketing materials*

250 words maximum

Please upload a headshot*

A high quality coloured image that we can use for print ads and digital media

Drop files here or

Accepted file types: jpg, png, Max. file size: 50 MB.

Administrative Contact Information

Name

First Last

Email

Phone

Is there anything else you would like to share?