Your Information

Your First Name *

Your Surname *

Email Address ( so we can let you know if the nomination is successful) *

Information for the person you are nominating

First Name *

Last Name *

Street Address *

Address Line 2

City *

Post Code *

Phone Number

Email Address (if you have it)

Please provide information about how you met the person you would like to nominate and why you think they should be considered for an award *

Your nomination will be passed to our awards committee and you will be notified if the person you have nominated receives an award we will email you to let you know.

Any information that you provide will only be used to consider your nomination and to dispatch an award to the nominated person if the committee decides an award is appropriate.

We will also notify you if your nomination is acceptable by email.

Please tick the box below to confirm that you are happy for us to use the data you have provided for this purpose *

I agree