MyBrokersIreland Awards 2017 Nomination Form
Nominator, Please fill in your details below

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:


Please enter the name of the person you would like to nominate and also include their job title and length of service with you or in the industry


350 characters left.

Please select which category (s) you would like to enter your nominated employee in for? (you can select more than one category)

Team leader of the Year
Customer Service Broker of the Year
Sales Person of the Year
Personal Lines Broker of the Year
Commercial Lines Broker of the Year
Outstanding Achievement award
Educational Achievement Award
Most Supportive Life Insurer Representative
Most Supportive General Insurer Representative
Broker Principal of the Year Award

What skills does the nominee exhibit that enables them to excel in their role? 


1000 characters left.

Please outline the principle reasons that prompted you to nominate this person for an award?


1000 characters left.

Please provide any other relevant information not already captured that might enhance the quality of this submission (Optional)


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If available, please include brief comment (s) from fellow colleagues and/or owner/Manager on the quality of this candidate


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