Designated Representative* Registration Form

This form must be completed by the organisation’s Designated Representative, as appointed by an executive officer (e.g. CEO or CTO). Please ensure you have the following information ready:

A duly signed and stamped copy of the Designated Representative Authorisation letter.
A scan copy of your government ID.

Enter the information exactly as it appears on the Designation of Representative Authority Letter and your government-issued ID.

*"Designated Representative" means an individual selected to represent his/her respective organisation for the purpose of enabling that organisation to attend and participate in AFRINIC’s AGMM, SGMM, and Public Policy Meetings (PPM), including participation in any AFRINIC 2026 elections. Accordingly, the Designated Representative shall also serve as the designated voter for his/her respective organisation.

Organisation Details

Organisation Name

ORG-HDL

Website

Organisation Address

Address

City

Country

Designated Representative

This is information about YOU, the designated representative.

Your First Name

Your Last Name

Your Work Email

Your Job Title

Your Phone/Mobile

Upload your government ID (Passport etc.)

Upload your government-issued ID

Signed Representative Designation Authorisation

Upload your SIGNED Designation of Representative Authority Letter

Nominating Executive

Provide details here regarding the Executive Officer (e.g. CEO or CTO) who is authorising this representation.

First Name

Last Name

Email

Official Job Title

I confirm that I have obtained the necessary consent from , to submit their personal data for the purpose of this process.

I confirm that the information I have provided on this form is true, complete, and accurate.

I hereby authorise AFRINIC to conduct such verification as is necessary regarding the information provided in this application.

I acknowledge that I may be required to provide my facial biometric data for any up coming 2026 election-related verification purposes.

I have read and understood AFRINIC’s Privacy Notice and hereby consent to the processing of my personal data in accordance with its terms.