A biography of the candidate (maximum 50 words).
Details of the candidate describing what they have achieved.
Details of their plans and the reasons why the candidate should be considered for the award (Maximum 500 words).
A recent photograph (Full face).
Supporting evidence for their stated achievements.
The names and addresses of two referees, Both referees must have known the candidate for at least two years.
Lifetime Achievement Award Nominations require 4 referees, nominees will not be interviewed
To download the document click on the buttons below:
All nominated candidates must have resided in Wales for the past 2 years.
All applicants should be at least 18 years of age except those applying for the Young Achiever Award.
Please return completed form to:
Prof Meena Upadhyaya,
‘Extraordinary Contribution to the COVID-19 Response’ Award
To nominate someone for the ‘Extraordinary Contribution to the COVID-19 Response’ Award, click the buttons below:
Please note the closing date for nominations is 21st May 2021.