Make a Nomination

This nomination form will take approximately 30 minutes to complete. Before completing the form, here are some things you may want to prepare/have ready to help with your application.

Pictures/videos/documents/evidence of the project
Quotes from people who have benefited/taken part
A detailed description of why you are making the nomination
Know which one category you are submitting the nomination for
Point of contact details for the individual who is completing the nomination

Once you have submitted a nomination, you will receive confirmation that it has been received within 72 hours. We will then follow up with next steps.

Your details
Name:*
Phone number:*
Email Address:*
Role:*
Organisation/Company/Trust Name (Full name, no abbreviations):*
Ward/ Service Name (where applicable):
Hospital/Unit (where applicable):
Company website*
Secondary contact details for this nomination
Name:
Role
Email
Phone
Nomination
Category*
You can only select one option. If we feel your application may be better suited in another category when we review it, we may change this.
Title*
Title of Initiative/Project or Name/s of person/s nominated (not initials)*
Summary*
A sentence to summarise the project/initiative/why the person is nominated. If successful this will be printed in the Awards programme, so 50 words is the strict limit
Full overview of project*
Provide as much detail as possible.
Key Details to Include:
- Who has worked on the project and how many people were involved?
- How long has the project been running?
- What makes this project or individual outstanding?
- Any quotes or testimonials to support the nomination
Attachments
Drop files here or

Accepted file types: jpg, png, mp3, mp4, pdf, Max. file size: 8 MB.
Attach pictures / documents / video links to support your nomination (if you need to send a larger file please contact [email protected] for additional support)
Invitation consent*
- I understand that if the nomination is successful, we will be invited to the awards.
Nomination consent*
- I understand that I will be expected to complete consent forms, risk assessments and be the lead person for this nomination.
Contact update*
- I understand that if I am no longer the main point of contact, I will provide you with the new contact details.
Contact consent*
- I understand that if the events team want more details of this project to support the application, they will be in touch.
If you have any questions, please contact [email protected]

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Comments
This field is for validation purposes and should be left unchanged.

Your details

Secondary contact details for this nomination

Nomination