Welcome to the nomination form for the 2017 Cure Leukaemia Champions Awards to recognise all of our incredible fundraisers in such a vital year. Please make your nominations below and remember if you want to nominate more than one person, you can do so by filling the form in again!

* 1. Your full name:

* 2. Your email address:

* 3. Your telephone number:

* 4. The name of the person you are nominating:

* 5. The award(s) you are nominating them for:

* 6. Why should this person win the award? (500 words Max)

* 7. Twitter handle of the nominee (If they have one)

* 8. Email address of the nominee (If you know it)

Nominations close on Tuesday 31st October 2017 and the Trustees of Cure Leukaemia will judge each category winner!

This year's event takes place on Friday 15th December at Hotel du Vin in Birmingham from 2pm.