Honorary Member applying for award 

Description of conservation activities/achievements

A.P.H.A. Full Member recommending this applicant

By checking this box, I assert that all information submitted is true and complete, and that I (electronically) affix my signature.

PLEASE EMAIL THE FOLLOWING INFORMATION TO THE A.P.H.A. EXECUTIVE OFFICER: executiveofficer@africanpha.org 

Letter of Support: It is mandatory to have a letter of support from the full
A.P.H.A. Member that is recommending this applicant.