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NATIONAL GEOGRAPHIC SOCIETY / BUFFETT AWARD

FOR LEADERSHIP IN AFRICAN CONSERVATION

Nominations must be received by January 22, 2016. Please complete and email this form along with the
nominees CV, if available, to:
Luisa Arnedo, PhD

National Geographic Society


conservationtrust@ngs.org

Part I: Nominators Information


Nomination submitted by
Title, Organization

Email address, Telephone

Part II: Nominees Information


Last (family) name
First (given) name
Title
Organization
Street address
State/Province, Postal code

Country
Telephone, Fax

E-mail address
For how many years has the
nominee worked in
conservation?

What other major awards has


the nominee been given?

Part III: Nominators Statement


Please describe the nominees major achievement(s) in conservation (2-page limit)