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Enter as much detail as possible to support your entry including examples of work you have undertaken

Your details

This is so we can contact you if your nomination is successful

First Name *

Surname *

Organisation *

Position in Business *

Email *

Phone *

Nominated individual’s Details

First Name *

Surname *

Organisation *

Position in Business *

Area of specialism *

Address line 1 *

Address line 2 *

Town/City *

Postcode *

Phone *

Email *

In what way have you demonstrated professional excellence within your sector in Wales? *

Why should you receive special recognition by winning this award? *

Would you like to provide us with any additional information to support your application? *

Interested in tickets if shortlisted? *

Yes please No thanks

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