Child Award Nomination Form - CCAA | Charity Supporting Children With JIA

NB: This Nomination form is just for awards for children and young people.
To nominate a Healthcare Professional for one of our new awards please click here.

Before completing this form, please ensure you have read our Nomination Guidelines below. If you are unsure which badge to nominate your child or young person for, there are some suggestions here. If you have any questions about any aspects of the process take a look at our FAQs or if you wish to discuss your nomination before proceeding, please contact us on awards@ccaa.org.uk.

CCAA Award Nomination Guidelines

Please only nominate a child or young person for ONE CCAA Award at any one time
CCAA Awards are only for children and young people living with a paediatric rheumatological condition and their siblings.
CCAA are very pleased to offer these awards to children and young people as we feel so many of them deserve this recognition. Please consider your nomination carefully and use the awards for whenever is most appropriate, helpful and special to the child or young person and their family. Thank you for your understanding!

Award Badge Nomination Form

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

1. Please give us the full name of the child or young person you would like to nominate for a CCAA Award

2. Please give us the age of the child or young person you would like to nominate for a CCAA award

3. Does the child or young person have JIA / another paediatric rheumatological condition or are they a sibling?*

4. Please give the FULL address and POSTCODE of the child or young person where you would like the CCAA award to be sent*

Street Address

5. Which CCAA award would you like to nominate them for?*

Please select only one award.

6. Please give the reason/s why you think they deserve this award and why you are nominating them*

This will be used to complete the certificate that comes with the award badge so please give a full explanation.

7. Is this the first CCAA award badge that this child has been nominated for?*

Yes

Not Sure (if you select this option we can check in our database for you no problem.)

8. If YES, which colour lanyard would they like to receive on which to collect their awards?*

Choose from the drop down list, yellow, black or blue.

9. Please leave us your contact details in case we need any more information to process the award*

First Name Surname

Relationship to child/young person being nominated

Phone

GDPR Check*

I accept the terms and conditions as to how my data will be used