Moorfields’ Stars 2014 nomination form
Chairman’s Award for an
Outstanding Individual
Name and job title of your nominated individual:
Please describe in no more than 400 words, how your nominee:
• Makes an outstanding contribution to the work of the Trust
• Achieved well beyond that which is expected in their role, whether locally, nationally
or internationally
• Inspires others
Nominated by (name):
Contact number:
We need this information so that we can contact you for more information but we won’t publish
it anywhere and nominees will not be told who has nominated them without your permission.