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Team/Individual Nominations Form

Nominate someone for a Chairman's Award in:

Chairmans Awards 2019 - Team and Individual

About the Team or Individual
Enter the full name of the person or team.
Enter job title
Tell us the hospital, clinic, or location where this person or team are based.
Please include a ggc or nhs email address if possible.
Tell us the best number to reach them on during office hours
Please set out the main reasons why you think this nominee(s) deserves an award. It is important to include as much information as possible about what your nominee(s) did and the difference they have made, giving examples wherever possible.
Tell us the story of this entry in a few words.
About you - the nominator
Name of the person making this nomination
Please provide a ggc or nhs email address if possible
Please give us the best address for us to contact you by post
Enter your postcode
Tell us where we can call you