Undergraduate Prize Nomination Form

Your Name ^* (required)

Your email ^* (required)

Institution where you undertook your degree ^* (required)

Your BNA membership number, (you can find this by logging into the BNA website and looking in "My BNA") ^* (required)

Please confirm that you have sent the following documents to the BNA office to support your application: 1. Letter of nomination from Course Tutor, Course Supervisor or Head of Department 2. Evidence of success in final summer examinations, including marks 3. Any supporting material, including final year dissertation/thesis, or a report on any research carried out by the student 4. A statement of career intentions. ^* (required)

YES, I have sent these documents to the BNA office.