Nomination Form South West Region ‘25

NOMINATION FORM for Midlands Region ‘26

Fill out the form carefully with as much detail as possible please use Google or Social Media for Contact Details Of Person or Organisation Your Are Nominating
Name of Individual or Organisation You Are Nominating For the Midland Region ASA *

Name of IndividualOrganisation Name
Their Email (if you don’t have it please check their website) *
example@example.com if you don’t provide the correct email address your nomination will not be valid.
Their Contact Number *
**Mobile Preferably** You can find this on their website or social media.
Your Name *

First NameLast Name
Your Mobile Contact Number *
Award Categories South East Region 2026

1) Animal Hero (Human over 18)

2) Young Animal Hero (Someone under 18 for their work with Animals)

3) Animal Hero (An Animal that has done something extraordinary)

4) UK Animal Rescue/Rehoming Organisation Of The Year Midlands

5) Pet Groomer of the Year

a) Mobile Groomer

b) Cat Groomer

c) Dog Grooming Tutor of the year

d) Dog Grooming Business of the year

6) Volunteer of the Year (must be a registered organisation) Single entry or team

7) Animal Therapist of the Year

a) Physiotherapist

b) Hydrotherapist

c) General Therapist

d) Holistic Therapist

8) Dog Services Award (Dog Walker, Sitter or Boarder)

a) Dog Walker

b) Dog Boarder

c) Doggy Daycare

D) Dog Sitter/Dog Fosterer

9) Animal Charity of the Year (must be a charity commission registered organisation)

10) Best Pet Related Business or Online Store UK

11) Best Animal Pet Food Supplier/Manufacturer

12) Small Animal Rescue ie Guinea Pig, Rabbits,Hamsters, Hedgehog's, snakes etc

13) Rescue Animal Of The Year

14) Working Dog Of The Year

Therapy Dogs,Assistance Dogs,Support Dogs,Facility Dogs, Police Dogs, Emotional Support Dogs,Service Dogs.

** please note only assistance dogs will be allowed to attend on awards night**

15) Cat Rescue/Rehoming Award

16) Cat Sitter,Cat Boarder,Cat Fosterer

17) Animal Trainer/Behaviourist of the Year
What category/Categories would you like to enter them *
Example 11016 equates to categories 1,10,16
Do You Agree To Us Keeping Your Details On File (We do not give your details to 3rd Parties) See our website for full privacy policy.*

YesNo
Do You Wish Your Nomination To Remain Anonymous (It’s nice for entrants to know who nominated them & it makes the nomination feel more valid)*

YesNo
**Please do NOT submit multiple nominations for the same organisation or ask people to vote! You only need one nomination to be entered. Multiple nominations will be discarded. Thank you**
Please verify that you are human*
Should be Empty:

NOMINATION FORM for Midlands Region ‘26