NOMINATION FORM Please note: ENTRIES CLOSE AT MIDNIGHT ON FRIDAY, JULY 15, 2022 Please read the HOW TO ENTER section before completing the form NOMINATION FORM1. NOMINEE’S First name2. Last Name3. Date of birth4. Age on November 11, 20225. Ethnic origin6. Address 1 – House number and streetAddress 2 – Village/Town or CityPostcode7. If not resident in Yorkshire, where in the county were you born8. E-mail address9. Home phone number10. Mobile phone number11. Company/organisation (where applicable)12. Current school/college/university (where applicable)13. Position or job title (where applicable)NOMINATOR’S DETAILS (If you are nominating someone, please complete the section in green below below:Only complete this section if you are nominating someone elseFirst NameLast NameAddress 1 – House number and streetAddress 2 – Village/Town or CityPostcodeE-mail addressHome or office phone numberMobile phone numberCompany/organisation (where applicable)Current school/college/university (where applicable)Position or job title (where applicable)How do you know the nominee (e.g. employer, colleague, friend etc)14. Which category are you entering? (PLEASE TICK ONLY ONE BOX)*YOU CAN ONLY ENTER ONE CATEGORY – NB: THE JUDGES RESERVE THE RIGHT TO MOVE YOUR ENTRY TO A DIFFERENT CATEGORY IF THEY FEEL IT IS MORE APPROPRIATESPORTHEALTH/MENTAL HEALTH & HEALTHCAREARTS & CREATIVE INDUSTRIESMEDIAEDUCATIONPRIVATE SECTORSCHOOL OR COLLEGEPUBLIC SECTORNOT-FOR-PROFIT SECTORYOUNG ENTREPRENEUROVERCOMING LIFE OBSTACLES15. What are your (if self-nominating) or the nominee’s achievements or exceptional contributions? (Max 200 words)*16. Explain why you (if self-nominating) or the nominee deserves this award and what impact your/their efforts have had. Please see entry criteria for more guidance) [Max 500 words]*17. Is there any additional information you would like to give in support of this nomination? [Max 300 words]18. I CONFIRM THAT THE INFORMATION I HAVE SUBMITTED IS ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF AND I HAVE ONLY TICKED ONE AWARD CATEGORY (check box)19. How did you hear about the YAYAs?Please tick any that applyNewspaperTV advertRadioWord of mouthOnline newsSocial mediaLeaflet20. Other (please state) belowSendThis field should be left blank