Breed Health Co-ordinator Award Application Form

The Breed Health Co-ordinator of the Year Award will be presented to an individual who currently holds the Breed Health Co-ordinator role and does a great deal of work for their breed in a volunteer capacity. The Award prize fund is intended to finance future breed health projects, subsidise health testing for the breed or contribute to health research; and further reward the winner's outstanding contribution in the field of canine health and welfare. The Prize Fund offered for this award is £5,000.

Please note that where the term "Nominee" is used, this refers to the person who is being nominated for the Award – even if you have nominated yourself.

Completed applications are to be received by 28 February 2022.

Nominator's contact information

(Please leave blank if you are nominating yourself)

Contact details of Nominee

(Please leave blank if you are nominating yourself)

Additional information about the Nominee

Membership of any professional bodies (please write in full and include dates)

 
 
 
 
 

References

Please provide details of at least two referees (please note that referees will only be contacted to provide a reference if the nominee is shortlisted)

Referee 1:

Terms of Application

  • If you are nominating someone else, please ensure they have given their consent before you submit the form.