The person nominating (nominator) must complete this form, indicating in no more than 200 words (1400 characters) why the nominated person (nominee) or clinical area should receive the award.

Nominations can be made by students (peer or self), by members of staff from the School of Nursing and Midwifery, or by relevant Health Service Providers.

If you are nominating individuals in different categories, please use separate application form for each nomination.