Brake Family Liaison Officer Awards 2018: entry form – Family Award

Thank you for your interest in entering Brake’s Family Liaison Officer Awards. Please read the terms and conditions and instructions below carefully, and fill out the requested details below.

Terms and conditions

1.Entries must be submitted by email to by 2 March 2018. You will receive an email confirming receipt of your entry. If you do not receive an email acknowledging your submission within 2 working days, please contact +44 (0)1484 559909.

2.If you are unable to use this form to submit your entry, please contact before the deadline to arrange alternative submission.

Instructions

1.Please complete all fields below.

2.You may find it useful to prepare your entry in a Word document or similar beforehand, then paste the relevant details into each box.

3.If you wish to provide any supporting evidence for your entries, please attach as PDF files.

4. To fairly judge the Awards, it is crucial that each entry includes as much relevant information as possible. Please supply as many details as possible so that we are able to accurately judge each entry.

Please provide the contact details of the person submitting the entry
Name
Telephone number
Email
About your entry
How did you hear about the Family Liaison Officer Award? (tick one) / Email from Brake☐
Phone call from Brake☐
Email from another source☐
Brake social media ☐
Read in Brake bulletin ☐
Brake website☐
Other website☐
Press/media☐
From friends/family ☐
Other (please state) - Other
Background information
If you would like to include some background information about the nominated individual, please include these details here. This information will be sent to the judges along with the evidence from the main award entrance. (maximum 300 words)
If you would like to include supporting evidence for your entry, please attach as a single PDFfile to your entry email (maximum two sides of A4).
This will be sent to all judges alongside your category entries.
Family Award
Nominated individual’s name
Job title
Nominee force
Nominee email address
Nominee contact number
Question 1:
Please provide a brief overview and background of your story
Maximum 250 words.
Question 2:
Please provide five examples of why you are nominating your Family Liaison Officer, and why you feel that they were exemplary.
Maximum 250 words.
Question 3:
Please answer the following questions about your Family Liaison Officer
Maximum 250 words. / Did your Family Liaison Officer personally inform you about the death of your loved one?☐
Did your Family Liaison Officer provide you with the Brake bereavement pack and helpline number? ☐
Did your Family Liaison Officer provide you with set times they would be contactable at?☐
Did your Family Liaison Officer always return calls, if they weren’t initially able to answer? ☐
Did your Family Liaison Officer regularly provide you with clear updates about the investigation? ☐
Did your Family Liaison Officer provide you with support at the inquest? ☐
Did your Family Liaison Officer continue to support you through any subsequent court proceedings?☐ /
Question 4:
In what way do you feel that your Family Liaison Officer’s attitude and aptitude were over and above what you would have expected?
Maximum 250 words.
Question 5:
How do you feel that your experience would have been different, if you did not have a Family Liaison Officer appointed?
Maximum 250 words.

Thank you for your time in completing this form. Following a judging period, where entries will be considered by Brake staff and an independent external panel of judges, the winner of this Award will be announced at Brake’s Annual Reception in June 2018.

If you would like any further information about the Award, please email .