ROI nomination form

WaterWipes Pure Foundation Fund nomination form for parents nominating a nurse or midwife working in the Republic of Ireland.

YOUR DETAILS

YOUR NOMINEE DETAILS

(e.g. Hospital/Practice/Unit/Clinic)

Please note: Click here to read the terms and conditions in full, including submission details, deadline, bursary fund information and judging criteria.* By submitting your nomination, you agree in full to these terms and conditions.

(Optional) I consent for my name and nomination entry, to be used in social media/marketing activities relating to the Pure Foundation Fund.

ENTRY STATEMENT

MANDATORY: Please outline how your healthcare professional has gone above and beyond to provide an exceptional level of care for you and your baby. Nominations should note how they were specifically involved in your pregnancy, birth or postnatal experience.
(approx. 500 words / 4000 characters)

The nomination deadline is November 30th, 2020.

For full terms and conditions, please click here.

THANK YOU FOR YOUR ENTRY

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