Please enter the details of the person making the Nomination
Your name *
Your email *
Telephone Number *
Enter below the details of the Person (of Group) you are Nominating
(note if you are nominating a group, please enter the name and contact details of the Lead Person)
Nominee Name *
Which Award are you nominating them for?
Note: If you feel they could fit into more than one category, please select the most appropriate and outline any other options in the Description Box.
Choose Category *
Community Impact - VolunteerCommunity Impact - EmployeeLived ExperienceBest FundraiserYoung person making most impactContribution to Domestic AbuseContribution to Sexual Violence
Please describe why you think they are deserving of the Award. Enter as much detail as you can - this will help the Judging Panel in their decision making. If you wish to submit any evidence/examples such as photos etc please do so.
Description * (approximately 300 - 400 words)
If you wish to submit any evidence/examples such as photos etc please do so here – this is optional but may help the Judges reach a decision.
Supporting Material (optional)
Please complete the form and submit it before Monday 9 October 2023 at 5:00pm. Your nomination will be emailed directly to our email@example.com email and will be entered before the Judging Panel who will meet on the 24th October. Winners will be contacted and invited to attend the celebratory Awards Evening on Friday 22nd March 2024 , to receive their prize and Award.