ROSCAs 2008 - NOMINATION FORM
 

Category 4 - The Service Users and Carers Choice (Individual)

Please note fields marked * are compulsory.

I am the proposer and my contact details are:


Name *
Address where you can be contacted *
Telephone Number
Email Address

I wish to nominate the following individual for this award:


Name and Job Title *
Department and Work address *
Telephone number
Email Address
Have you informed them of your nomination? * Yes No

 

4. The Service Users and Carers choice (Individual)

Nominations for this award can only be made by service users or carers who have contact with 2gether NHS Foundation Trust and it is intended to allow service users orcarers to nominate an individual who in their opinion has made an outstanding contribution. This contribution could be in any area: clinical care, service userinvolvement, administrative support. The decision is entirely up to the proposer.

When you nominate a person please consider:

  • What your nominee does that is outstanding and worthy of recognition.
  • Describe who benefits from what this individual does.
  • Identify anyone else e.g. another service use or carer who feels the same way about this individual


My Reasons for Nominating this Individual

In this section please summarise why you feel your nominee deserves the award. Please focus on how they make a real difference and how they meet the criteria for this award.  It is really helpful if you could give as much information as possible about your nominee and why you think they are different and special.

The judging panel want to know about your nominee and will use your information to assess the merit of each nomination. You can use an additional sheet if you need more space, giving specific examples/evidence to support your nomination to help the judging panel.

What does your nominee do that is outstanding and worthy of recognition?


Who benefits from what your nominee does?


Who else e.g. another service use or carer feels the same way about this individual and what do they say?


Any other information which you want to share with the panel in support of your nominee



Please read the following section carefully:

The information I have given is correct to the best of my knowledge. I understand that I may be asked for further information. The decision of the judges will be final and no correspondence will be entered into relating to the decision/s of the judging panel. All nominations and winners will be publicised to help promote the overall work of the Trust and its staff and to promote positive images of mental health, learning disability and substance misuse services.

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To confirm that you have read and understood the information above, please click on the 'send' button.