Nomination of Authorized Representative

In the event the Lead | Head | CEO of the member or the authorized representative as indicated on the member application form cannot attend the General Assembly, the Lead | Head | CEO shall appoint a representative to represent the member and vote on behalf of the member.

In the event the Lead | Head | CEO or the authorized representative as indicated on the member application form cannot attend the General Assembly and no representative has been appointed prior to the election day, the member will not have the right to vote.

Complete the Nomination of Authorized Representative Form online within the deadline mentioned below.

Saving a draft of this form to be finished, reviewed and/or submitted later is not supported. Make sure to have access to all information required in the form before starting to fill in the form.

Should you wish to make amendments after submission, complete and submit the form again. The most recent submission will be considered valid.

Provide only work emails. Please make sure you have obtained the necessary permissions to do so when providing other persons' emails.

Nomination Deadline

On or before 12:00 pm, Monday, February 19, 2024

I, the undersigned, in my quality of the Lead | Head | CEO of the member company mentioned below, wish to appoint a representative to represent the company at the IAB's General Assembly on February 21, 2024 and to vote on my and company’s behalf during the meeting and at any adjournment thereof.

GA: Nomination of Authorized Representative

Authorized Representative

First Name

Last Name

Position

Phone number

Company

Company Name if Other

Member companies only can attend the IAB MENA General Assembly.

Authorization Given By

Member Company Name

For members benefiting from group membership, select the group company holding the membership.

Lead | Head | CEO Name

The nomination will not be accepted if the name provided in this field is the same as the name provided in the section above.

The nomination will not be accepted if the email provided in this field is the same as the email provided in the section above.

Phone number

Signature*

I acknowledge that clicking on the Submit button below is equivalent to signing the form.

CAPTCHA

Warning

The SUBMIT button has been disabled because your company is not a member of IAB MENA.

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