Public Engagement Nomination Form

Your Name ^* (required)

Your email ^* (required)

Email address of nominee (if known)

Why should this person be considered for the award? Please make a case for why the nominee should be recognised for their work, in any capacity, in the field of public engagement in neuroscience. (Maximum 4000 characters including spaces, alternatively please send this information to the BNA office as a word document supporting your application.) ^* (required)

Please say if you feel that, not only the individual named above, but also their team / group should be recognised. ^* (required)

Yes, it would be more appropriate for a whole team/group to be recognised and awarded.

No, it would be more appropriate for the individual to be recognised and awarded.