Nomination Form

Bravery Award Nomination Form

NOMINEE DETAILS

In this section please set out details of the deed carried out by your nominee. It is important that you give as much detail as possible (including weather conditions/environmental details).

YOUR DETAILS

(This address will be used for an acknowledgement and any future correspondence)

Alternatively download the form in either MS Word or PDF Format below:

Nomination Form (MS Word - 37KB)

Nomination Form (PDF - 57KB) 

 

Please send this form and any enclosures to

Secretary

National Bravery Awards Secretariat

51 St. Stephen’s Green

Dublin 2

Phone: + 353 1 602 8202

Fax: + 353 1 6615461

Email: sec@bravery.ie