Rehab People of the Year

Nomination Form

If you experience any difficulty completing this nomination form please email peopleoftheyear@rehab.ie

Nomination Category

Please select:

Person or Group nominated

Name:

Address:

Age (if under 25):

Contact telephone number:

Email:

Nominated By

Name:

Address:

Telephone:

Email:

Organisation and title
(if applicable):

Nomination (please provide at least 300 characters / 50 words)

If you have any information to support your nomination which you would like to include for example news clippings, photographs, or reports please upload them below:

Supporting Documentation:

Upload:

Supporting Documentation:

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Supporting Documentation:

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How did you hear about the People of the Year awards?:

Days left to nominate

About the Awards

Nomination Form

Nomination Category

Person or Group nominated

Nominated By