VOMI Global Think Tank - Official Global Ambassador

1
OGA ID#
2
Today's Date* This field is required.Shown for your reference only. Cannot be modified.
Date
Month
Day
Year
20
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Hour
10
00
10
20
30
40
50
Minutes
3
Full Name* This field is required.Your full legal name in the order given. NO initials, titles or salutations.
First Name
Last Name
4
Home Address* This field is required.No P.O. Box or business office address - Must be actual residence.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Cell Phone* This field is required.No calls will be placed. Will be used strictly for SMS (text messaging) related to cybersecurity and emergency notifications.
Area Code
Phone Number
6
Your Email* This field is required.Must be a "personal" email address. NO corporate email address provided by your employer or other organization.
7
Current Full-time Employer* This field is required.
8
Current Job Title* This field is required.
9
Official Website* This field is required.Employer website.
10
LinkedIn or Other Social Media Profile* This field is required.Only provide us with the URL link to your profile. Do NOT input your resume or profile here.
11
Your Photo* This field is required.Cybersecurity measure designed to prevent identity fraud and confirm your online identity for videoconferencing purposes. Must be a clearly visible "headshot" photo. NO dark sunglasses, head or face coverings, icons, logos, spouse or friend or girlfriend or children or pets, or scenic places in photo.
Drag and drop files here
Select files to upload
Min. file size1.0KB, Max. file size: 20.0MB
Maximum file size - 20 MB.
Cancelof
12
Your Executive Profile* This field is required.Upload your executive profile, professional resume, or CV. A PDF version is preferred.
Drag and drop files here
Select files to upload
Min. file size1.0KB, Max. file size: 10.0MB
Cancelof
13
Reason for wanting to serve as Official Global Ambassador* This field is required.Give us the most compelling reason why you seek to become an Official Global Ambassador.
Huge
Large
Normal
Small
Ok
Ok
14
OPTIONAL - Comprehensive answer for wanting to serve
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
Cancelof
15
Country of Interest* This field is required.Your country of residence is preferred, however, that is NOT required.
16
PERSONAL REFERENCES
17
Name of Personal Reference #1* This field is required.
18
Reference #1 Email* This field is required.
19
Name of Personal Reference #2* This field is required.
20
Reference #2 Email* This field is required.
21
Who Referred You to VOMI Global Think Tank* This field is required.This information will be very helpful in speeding up the processing of your membership application.
Invitation from Founder of VOMI Global Think Tank
Another Official Global Ambassador
A Friend, Colleague or Associate
Read an article by the founder
Other
22
Name of Official Global Ambassador* This field is required.
First Name
Last Name
23
Name of Friend, Colleague or Associate* This field is required.
First Name
Last Name
24
Authorization to verify application information

You hereby acknowledge that your submission of this application constitutes authorization to VOMI Global Think Tank et al to verify the information herein provided.
25
Let us know you are a real person* This field is required.
Should be Empty: