Birth of a New Nation Event Partners Registration Form

Birth of a New Nation Event Partners Registration Form

Please complete this form to be added to the Event Partners Database. By completing this form, you will receive Event Planning meeting notifications, event updates, and other pertinent information about the Birth of a New Nation event in Atlanta 2024.
Name

First NameLast Name
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Do you use WhatsApp?

YesNo
Are you a member of the One Afrika WhatsApp group?

YesNo
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If you have a company or organization, what is the name?
This will be used to credit your organization or company's participation. This will also be used to create your unique custom code.
Industry
Which committees are you most interested in serving on? (Please select 1 or more)

Event Programming and Operations CommitteeVenue and Logistics CommitteeMarketing and Publicity CommitteeSponsorship and Fundraising CommitteeSpeaker and Entertainment CommitteeExhibitor and Vendor CommitteeVolunteer Recruitment and Event Staffing CommitteeHospitality and Guest Services CommitteeTechnology and Audiovisual CommitteeAccessibility and Inclusivity CommitteeSecurity and Safety CommitteeEvaluation and Feedback CommitteeInternational Relations and Cultural Engagement CommitteeGlobal Media CommitteeHealth and Sanitation CommitteeTraditional Rulers and Royals Hospitality CommitteeTranslation and Interpretation Committee
Optional: How do you classify yourself?

African/AfrikanBlack AmericanAfrican AmericanIndigenousMoorishHebrew Israelite or JewAmerican IndianCreole or Gullah-GecheeAfro-LatinoAfro-AsiaticAfro-Caribbean or CaribbeanAboriginalBlackOther
Should be Empty: