Background Information

33% of survey complete.

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* 1. I hereby apply to run for being elected to the IWA Strategic Council in the following Member segment: (Please indicate which member segment is applicable in your nomination, tick only one checkbox below)

LIC - Low Income Countries --- Check the list of Low Income Countries please click here (see the last page)
Other segments - any other segment that is not covered in the options

For nominations to Specialist Group Rep, please skip Question 4 and go directly to Question 5; For all other nominations, please  answer Question 4 and skip Question 5

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* 2. Personal data

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* 3. Your IWA membership number (personal or corporate):