NOMINATE.FORM.TITLE

All fields marked * are mandatory

1. Please provide your name and contact details

Please complete your full name:

Please provide the following contact details:

Are you nominating on behalf of any organization (as a member or as an affiliated person)?

Yes

2. Tell us whom you are nominating

What is/are the full name/s of the individual or a group of people ("Nominee") that you are nominating for the Aurora Prize? If you are nominating a group, please list the names of all individuals. *

What is the occupation of the Nominee [if applicable]?

3. Explain what actions the Nominee undertook to help others survive *

Please provide answers to the questions below:

OBJECTIVE

Why are you nominating this person / group of people? (max 300 words)

COURAGE

How has the Nominee demonstrated courage in helping others survive? (max 300 words)

Within your response, please address the following questions

Has the Nominee risked his or her own life for the sake of helping others survive threats to their lives?
To what extent did the Nominee’s actions involve going beyond the call of duty of professional obligations for the sake of helping others survive?

COMMITMENT

How has the Nominee demonstrated a commitment to helping others survive threats to their lives through their actions? (max 300 words)

Within your response, please address the following questions

Has the Nominee demonstrated a direct involvement in helping others survive?
What was the Nominee’s motivation or reason for carrying out these actions?

IMPACT

What impact did the Nominee’s actions have on the community or country that the actions took place, or on the world at large? (max 300 words)

Within your response, please address the following questions

Did the Nominee save lives directly? If so, to the best of your knowledge, how many individuals survived thanks to the Nominee’s actions?
Have the Nominee’s actions saved more lives since?

4. Upload supporting evidence

Please upload supporting evidence that documents the Nominee’s work and impact (e.g., coverage by reputable internationally recognized media, awards, published works, third-party recommendations letter or other endorsement – max 10 documents and/or links).

Please note that supporting evidence is obligatory. Secretariat reserves the right to decline a nomination that is not supported by evidence verifying the Nominee’s story.

Supported files *.txt, *.rtf, *.pdf, *.doc, *.docx, *.jpg, *.jpeg, *.png, *.gif

Browse

URL

Is there anything else you would like to add to your submission or tell us? (max 100 words)

I agree with the Terms and Conditions, confirm the above is accurate, and consent to be contacted by the Secretariat if the nomination is shortlisted.