Dementia Friendly Awards 2017 - Nomination Form for Northern Ireland

Enter your nomination below

Please complete the following questions to enter your nomination for the Alzheimer’s Society Dementia Friendly Awards 2017 in Northern Ireland.

The final date to submit nominations will be midnight on 15 September 2017.

We suggest that you copy and paste your answers to the questions 7 – 11 in a separate word document, for your own reference and in case of any problems when submitting your form.

If you are nominating for a Journalist of the Year award and would like to include an article/clip or a series of articles/clips, please email these to conferences@alzheimers.org.uk after you have submitted your nomination form. Please include the name of the nominated journalist in your email.

 

Help: Please be careful with spelling, as the name written will be used in all future press/marketing etc.
3. Are you nominating yourself? * Required
Help: Please note you will be contacted using this email address for further correspondence about this nomination.
Help: Such as background, aims, demographic and context of the project/organisation.
12. Are you happy for your nomination to be used a case study by Alzheimer's Society following the awards ceremony? If used as a case study, your entry may be shared with externals groups and organisations as an example of good practice, or to provide ideas for others looking to complete similar work. * Required
14. If you are nominating on behalf of a business or organisation: Are you happy to be contacted by the Alzheimer's Society regarding partnership opportunities?
15. By supporting us, you’re doing something incredible to help thousands of families affected by dementia. We’d to keep in touch, and update you on the latest news, including the amazing work we do with our services and research, and how you can do more to help with fundraising, campaigning, or volunteering. It’s totally up to you – you can update what you get at any time and we’ll never sell your details to third parties. If we can’t reach out to you for help when we need it most, our work can’t continue – so please, choose to stay in touch using the boxes below and help us beat dementia.