Award Nomination Form You are nominating for: Award Nominations --- not set --- About You We may need to contact you about your nomination. Please provide us with your details. Your Name (required) Your Email Address (required) Your Telephone Number (required) Your connection to the nominee (required): Sharing the nominee's information Before you give us any personal data about the nominee, please confirm that you have their permission to give it to us. Declaration I have permission to share the nominee's details Your Nomination Please provide the Nominee's name (Required) This might be a person, a team or an organisation. If a team or organisation, please add a contact name after the team/organisation name. The Nominee's Role (Required) Please give some context to their role. This could be a description (e.g. 'family carer'), a job title, a volunteering capacity, or whatever you think relevant. Why are you nominating them? Please describe why they deserve this Award. What makes their work exceptional? How does it align with the judging criteria in the Award description? (Required) Reason why my nominee deserves this award: The difference they make Who has benefited from their work, and how? Perhaps give some stories or describe positive outcomes. (Required) Their Impact: Dementia Community Values How do they reflect Dementia Community Values? Learning, Sharing, Inspiring (Required) Alignment with Dementia Community values: File Attachments (Optional) If you wish to include one or more file attachments in support of your nomination, please do so here. Please Note: any attachments should directly support your nomination (e.g. feedback, evidence of impact, photos of the service in action), not simply be generic brochures; max filesize 5Mb; overly long or large attachments may count against you. (Optional) Attach file(s): Add new Links to additional supporting evidence (Optional): if you would like to include one or more links to additional supporting evidence, please add them here (please include https://). Add new Next Steps Shortlisting for Award Finalists takes place by 14th March 2026. In the event that your Nominee is shortlisted, we will want to get in touch with them. (Required) How should we get in touch with them? Via me Direct to Nominee Nominee email Nominee phone number Please validate reCAPTCHA By submitting this form you give permission for Dementia Publishing Ltd to hold and use the information you have provided, for the purposes of administering the UK Dementia Awards. You understand that the information may be shared with judges who may be external to the organisation.
