* Your name * Your job title * Your company name * Your company website URL * Date of birth * Email * Phone * Please provide a headshot of yourself Select Files File uploading Click 'Upload' button to change image/file. Upload files Crop Image Width: Height: Lock proportions: Resize Image * Why do you belong in the Care Show Thirty Under 30 Class of 2024? * Please provide a summary of your skills, strengths, and achievements. * Where will you be in five years' time? * Please provide a testimonial from a peer or colleague. If you would like to, please provide the URLs to your social media accounts. Privacy Policy For further information on how CloserStill Media manage personal data, please see our Privacy Policy. Submit
