Chesney Award Nomination Form 2024

Nominations can be made by any SoR member by completing the form below

All nominations must be received by 31st August 2024

The winner will be announced at the NRC Regions AGM.

Nominee:

1. Name of Student / Apprentice: *This question is required.

2. SoR Membership Number: *This question is required. This question requires a valid number format.

3. University: *This question is required.

4. Hospital placement: *This question is required.

Nominated by:

5. Name: *This question is required.

6. SoR Membership number: *This question is required. This question requires a valid number format.

7. Job title: *This question is required.

8. Hospital / Trust: *This question is required.

9. Why do you think the nominee deserves this award? *This question is required.

Please confirm before submitting your form