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* 1. Your Name:

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* 2. Your Company Name:

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* 3. Your email address:

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* 4. Contact Phone Number

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* 5. Are you making this nomination on behalf of your company?

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* 6. For which Award are you making this nomination?

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* 7. Who is your nominee? (Individual or Organisation).

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* 8. In which county or counties is the impact felt? 

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* 9. Why are you nominating them? What has been their impact?

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* 10. What else would you like us to take into consideration?

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* 11. Can you share testimonials by other parties (paste in, hyperlink)?

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* 12. Their website & other social media accounts (Twitter, Facebook etc)

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* 13. If we need more information whom should we contact ?

 
100% of survey complete.

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