2 supporting letters, where available, should be included with the nomination.
Last (Family) Name:
Organisation (if applicable)
Relationship to Nominee
* 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:
Have supporting letters been included: