PDSA - Form 1
Presidential Distinguished Service Award for the Irish Abroad 2020
Nomination form to be completed by Nominator
Nominee Details
First Name:
Last (Family) Name:
Country of Residence:
Organisation (if applicable):
Nominated By:
Local Irish Embassy:
Award Categories
Please select one category from the list below. If you wish to nominate someone under a number of
categories, a separate form should be submitted under each category.
Arts, Culture and Sport
Business and Education
Charitable Works
Irish Community Support
Peace Reconciliation and Development
Science, Technology & Innovation
The Nominee - Background Information
In 250 words or less, summarise the specific reasons why you think your nominee should be
recognised under the chosen category:
Supporting Documentation
2 supporting letters, where available, should be included with the nomination.
Nominator Information
First Name:
Last (Family) Name:
Organisation (if applicable)
Relationship to Nominee
(if applicable)
E-mail address:
Postal Address:
Telephone Number:
Notes:
* If you wish to nominate an individual under a number of categories, a separate form should be
submitted under each category.
* Completed nominations should be forwarded to the Embassy of Ireland of the country in which the
nominee is resident. Only completed nominations received by the closing date will be considered.
A full list of Irish Embassies and their contact details is available at:
www.dfa.ie/embassies/irish-
embassies-abroad/
Have supporting letters been included:
Yes
No
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