Nomination Form - The People's Honours Step 1 of 4 25% The British Citizen Award Medalists are selected to receive the recognition – individuals do not ‘win’ a BCA but are presented with the honour. Only a limited number of British Citizen Award medals are presented each year. They are carefully considered by the Independent Assessment Panel and each nomination is given a rigorous review before moving to the next stage. Further information or validation may be sought. Any candidate not progressing to medalist stage, should be aware that this does not diminish the achievements of the candidate in any way, and should not be viewed as a negative response, it is simply the criteria which dictate the success of nominations and it is this process which makes the awarding of The People's Honours so significant to those who receive it. Supply as much information as you can to validate your nomination – please also read Entry Regulations below. I wish to nominate the following candidate and I am supported in this application by one other person (seconder). I confirm that I am not related to the candidate.How did you hear about The People's Honours Please select either The British Citizen Award or The British Citizen Youth Award (under 18)(Required)Please chooseThe British Citizen AwardThe British Citizen Youth AwardNominee (person being nominated)(Required) MissMrMrsMsProf.Dr.Rev. Title First Name Last Name Contact Address (Full) Address Line 1 Address Line 2 Town County Postal Code Date of Birth (if known) DD slash MM slash YYYY Approx Age (if D.O.B unknown) Home / Business phone Mobile(Required) Email(Required) Member of Parliament (if known) Constituency Name of MP Is the Nominee aware of this nomination – the completed nomination form will not be disclosed to the nominee(Required)Please chooseYes, the Nominee is aware of being nominatedNo, the Nominee is not aware of being nominatedPlease note: Nominees will be informed in the event of being honoured a BCA, deferral or request for further information by the assessment panel. Parent/Guardian Mobile / Home(Required) Parent/Guardian Email(Required) Name of Parent/Guardian(Required) Please confirm Parent/Guardian approval(Required) Yes, approval is confirmed 1. Categories – choose category you recommend - If left blank, the assessment panel will determine the most suitable category relating to the nominationPlease select ClassificationPlease chooseBCAc for Services to CommunityBCAi for Services to IndustryBCAa for Services to ArtsBCAe for Services to EducationBCAh for Services to HealthcareBCAb for Services to BusinessBCAv for Volunteering & Charitable GivingBCAo for International AchievementBCAr for Services to Recreation and SportsIf unsure, please leave blank and the assessment panel will decide most appropriate Classification.2. Please complete in the box below why you consider the Nominee should be considered for The British Citizen Award (approx. 300 Words)3. What in your opinion makes this Nominee’s contribution exceptional? (approx. 300 Words)4. Has the Nominee’s contribution positively impacted a community, and if so, how? (approx. 300 Words)5. How long has the Nominee been engaged in the activity you have described in this submission and what has been the biggest impact? (approx. 300 Words)6. What other recognition (if any) has the nominee received for the activity described in this nomination (approx. 300 Words) -7. Is there any additional evidence to support your nomination?Please chooseYesNo*Supporting evidence could be, but not limited to, press cuttings, testimonials, personal references, web coverage, letters from Charities etc. Please upload copies or web links where appropriate, clearly marked with your candidates name on the tag line.Upload any evidence if available Drop files here or Select files Max. file size: 10 MB, Max. files: 10. Nominator details Nominator Name (person completing application)(Required) MissMrMrsMsProf.Dr.Rev. Title First Name Last Name Relationship to Nominee: Nominator MUST NOT be related to, or reside at the same address as, the nominee)(Required) Contact Address (Full) Address Line 1 Address Line 2 Town County Postal Code Contact number(Required) Email(Required) DECLARATION - See Nomination Regulations below before signing Declaration(nominations will not be accepted without signatures) I, the nominator, hereby confirm that the above information is accurate and true to the best of my knowledge and beliefSignature of Nominator(Required) Use your mouse (if on a computer) or your finger (if on a phone or tablet) to draw your signaturePrint full name of Nominator Nominator Undertaking(Required) By ticking this box you are giving an undertaking that the information provided in this nomination is true and accurate to the best of your knowledge. You are also giving an undertaking that the e-signature provided is a representation of your own signature and is to be treated as if you had signed the physical document.Entry Rules and Regulations(Required) By ticking this box you confirm that you have read the Entry Rules and Regulations that can be found HERE. Seconder Name (Person validating application)(Required) MissMrMrsMsProf.Dr.Rev. Title First Name Last Name Date of Birth(Required) DD slash MM slash YYYY Relationship to Nominee(Required) Contact Address (Full) Address Line 1 Address Line 2 Town County Postal Code Phone number Email(Required) Seconder Undertaking(Required) By ticking this box you are giving an undertaking that the Seconder has seen and approved the nomination and given you consent to provide their personal details on their behalf. An email will be forwarded to them when this nomination is submitted.Upon clicking the "submit" button below, please wait for a confirmation message before closing down the page. © Awards Recognition Bureau
