Entry Form
 

“Thanks for a great evening.”

R.W., London Midland

 

 

About the person you are nominating:

Which Category would you like to nominate someone for?

     

Name

 

Job Title

 

Which Company do they work for

 

Location of Work

 

1) Why are you nominating this person? (eg. Friendly, helpful, reliable, brave)

2) Please provide an example of the above

 

Date event took place:

 

 
Nominee's Line manager

Name:

 

Job title:

 

Email

 

Telephone:

 

 
 

About you

Your Name:

 

Company who you work for:

 

Your Job Title

 

Daytime Telephone Number:

 

Email:

 

Please enter the text from this image:
 

Captcha

 

 
 
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