TEDxNHS 2018 Speaker nomination form Survey

If you know someone who belongs on the TEDxNHS 2018 stage, or if you belong there yourself, we want to hear from you!

TEDxNHS 2018 aims to bring together ordinary people who choose to do extraordinary things, and in doing so, become part of something greater than themselves. The event, run voluntarily by people in the NHS, aims to be filled with influential and inspiring speakers.

TEDxNHS 2018 will take place on Tuesday 21 August 2018 at the incredible BFI IMAX, London.

Please complete this speaker nomination form to let us know who you want on the TEDxNHS 2018 stage!

1.I am nominating:(Required.)

Myself

Someone else - you know personally

Someone else - you do not know personally

2.Which TEDxNHS 2018 topic(s) would the nominated speaker be most suited to?
Each talk will fall into one of these three themes. Make sure your nomination falls into one of the below for the best chance of being selected. Tick all that apply.

(Required.)

Infectious Ideas: Disruptive innovations that go viral

Untold Stories: The everyday extraordinary

Evolution: Imperfections, survival and learning to adapt

3.Please rate how original/ fresh/ novel is the material/ story/ idea that you are nominating for?(Required.)

4.Please tell us more about the nominated speaker, this could include:
- Their work or experience
- Honours and distinctions
- Why are you recommending them(Required.)

5.Please tell us more about your ideas for this possible TEDxNHS 2018 talk, this could include:
- What inspires you about them?
- What expertise do they bring?
- What ideas do they have?
- What might be the title of their talk?(Required.)

6.Has the nominated speaker spoken publicly before?(Required.)

Yes

Unsure

7.Please rate how well you think the nominated speaker could communicate their thinking and develop it into a successful talk:

8.If possible, please provide links to any articles or web pages about the nominated speaker:

9.About you:(Required.)

First Name

Surname

Email Address

Telephone

Occupation/ work experience

Twitter Handle (@...)

LinkedIn Profile URL

10.About the Nominee (if not you)
Please complete as many as possible(Required.)

First Name

Surname

Email address

Telephone

Occupation/ work experience

Twitter Handle (@...)

LinkedIn Profile URL

Any further information that may help the team to contact the nominee:

11.Employment or experience of nominated speaker:(Required.)

Employed in NHS

Employed within NHS arms length/partner/affiliated bodies i.e CQC, AHSN

Expert by Experience (inc patient)

Employed within University/Education provider

Student

None of the above

Other (please specify)

Data protection
Data provided WILL NOT be passed on to any 3rd party company for the use of marketing or any other uses. Data is used solely by the TEDxNHS 2018 team to help in the decision process. Contact information will be used to contact individuals for the purpose relating to TEDxNHS 2018 only.

12.Can the TEDxNHS 2018 team contact you about the information that you have supplied in this nomination form?

If you select No we will be unable to contact you regarding this application.(Required.)

Yes

13.Do you want to receive further information from TEDxNHS 2018, including details on future ticket sales and event updates?

If you select No we will be unable to contact you regarding any TEDxNHS 2018 news in the future.(Required.)

Yes

Thank you for completing this nomination form

For latest updates see the TEDxNHS 2018 website and follow us on Twitter -roll on the 21 August!

Responses to nominations

TEDxNHS 2018 is run voluntarily by aspirant leaders within the NHS and due to the high number of nominations received we are unfortunately unable to provide individual responses to unsuccessful nominations.

If you do need to discuss your nomination further please email: Curation@TEDxNHS.