Impact Award Application Form
Use this form to apply for an Impact Award; either for yourself or to nominate someone else or a team.
1. Your Details & Summary
Please fill your details out below, even if the application is for someone else, as we will use these details to confirm if the application was successful.
1.1 Your Full Name
*
First Name
Last Name
1.2 Your Role
1.3 Contact E-mail
*
example@example.com
1.4 Your Organisation
2. Details of the Nominee
State who is being nominated for the award. It could be yourself, another individual, a team or an organisation
2.1 Award Category - are you nominating yourself, another individual, a team or an organisation?
*
Myself
An Individual
Team
Organisation
2.1.1 Please state below the name Individual you are applying for
2.1.2 Please state below the name team you are applying for
2.1.3 Please state below the name Organisation you are applying for
2.2 Nominee contact email
*
example@example.com
2.3 Nominee(s) organisation
2.5 If you are not applying for yourself, what is your relationship with the nominee (individual/team/organisation)
For example: manager, colleague, customer etc...
2.6 Reason for nomination
*
Briefly state the reasons why you are making this application
2.7 Supporting documents to go with the application - if applicable
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3. Consent and Submit
Consent or not to Lean Competency Services Ltd collecting and storing data from this form for the purpose of managing Impact Award applications. Not consenting will mean that the application cannot be processed.
Consent
*
Yes
No
Date
*
-
Day
-
Month
Year
Date
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Submit
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