Impact Nomination Form - NOW CLOSED FOR 2023

This form is to nominate yourself or someone else to be part of the 2023 Impact cohort. 

For more information on the questions, the Impact programme and what it's about - check out the Impact FAQ

If you have any reasonable adjustments or need support in filling out this form, please email

Our Privacy Policy outlines our Data Protection Policy in line with the Data Protection Act 2018 - For any questions related to your data, get in touch with our Data Protection Officer.

If you are submitting after 6pm GMT on 24th May 2023, please contact beforehand.
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Email *
Your Name *
Your Job Title *
Company *
Job Seniority *
Are you nominating yourself, or someone else? *
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