Outstanding achievement awards nomination form

Make sure you provide any other supporting information to explain to the judges why you feel the candidate you are nominating deserves an award. The judges can only make their decision based on the quality of the information you provide.

I am nominating a person / group for an award in the following category:

Category A - Outstanding achievement by a young person

Category B - Selfless service to a voluntary body or the community which is of a social or environmental nature

Category C - Sporting Achievement

Category D - Community or voluntary group that improves the quality of life for residents in the district

Category E – Individual or group that makes the district a safer place to live

Individual or group? *

Individual or group?

Individual

Group

Name of person you are nominating

Name of group you are nominating

Contact details of the person or group you are nominating

Address

House Name

House / Flat Number *

Street Name *

Town / Village *

County *

Postcode *

Daytime telephone *

Email address *

Date of Birth *

Date of Birth

Does this person/group know they are being nominated for an award?

Yes

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Outstanding achievement awards nomination form