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* 1. Which award are you submitting a nomination for:

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* 2. Please tell us the full name of the person you are nominating:

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* 3. If your nomination is for one of the Research or CF Care awards, please tell us the research centre, CF centre or hospital that your nominee works in. If this is not applicable, please state N/A:

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* 4. How long have you known the nominee?

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* 5. What is your relationship to the nominee?

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* 6. Why are you nominating this person? (110 words or less)

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* 7. Why do you think this person deserves the award more than anyone else?

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* 8. Please tell us your full name?

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* 9. Please tell us your email address:

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* 10. Please tell us your telephone number:

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* 11. Whereabouts in the UK does your nominee live? (Please be as specific as you can - town or city, county and country)

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* 12. Is there anything else you think we need to know about your nominee, that will support your nomination?

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* 13. We’ll only use your personal data to contact you if the person you nominate is shortlisted, so we can get in touch with them. We’ll keep your data private and secure, and will not publish or share it with anyone. For full details on how we use and keep your data safe, please see our privacy policy: https://www.cysticfibrosis.org.uk/privacy-policy. If you have any questions or concerns please let us know.

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