Nominee profile for the UICC Board of Directors 2016 - 2018

Please provide us with your profile information for inclusion in the UICC Board of Directors (BOD) Nominee Booklet.

  • Please enter your details exactly as you wish for them to be displayed in all communications.
  • If you do not complete this form, your profile will not be included in any capacity in the 2016 General Assembly communications or promotions. 

NB: Incomplete forms cannot be saved. Please have your responses ready to copy in when you complete the form.


(eg Dr, Prof., Mr, etc.)


In responding to the following questions, we suggest that you address the following in your responses:

  • What skills and international experience can you bring to the UICC Board of Directors
  • In which of UICC's priority areas can you be involved to make a difference
  • Current BOD Members - please describe your contribution to UICC to date
Maximum 1500 characters (approx. 250 words)
Maximum 1500 characters (approx. 250 words)


Please provide us with an image that you wish to accompany your profile.
It must be:

  • An image showing you from shoulders and above.
  • In either of the following formats .jpg or .png
Please provide an image showing you from shoulders and above in either .jpg or .png formats.
Files must be less than 4 MB.
Allowed file types: jpg jpeg png.


For the administrative purposes of this form, please provide us with a contact email address and phone number.
Please note that this will remain confidential and will not be published.

Please include country code and area code