KĀPITI COAST CIVIC AWARDS 2022

KĀPITI COAST CIVIC AWARDS 2022
Civic Awards recognise the efforts of people who are helping make our community vibrant, diverse and thriving.

We would love to hear from you! This is your chance to nominate a group or someone you know who deserves to be recognised in our community.

Join us in celebrating the amazing volunteers who make Kāpiti great. Nominations for the 2022 Kāpiti Coast Civic Awards are now open until Tuesday 31 May 2022, 5pm.

The successful nominees will be presented with their award at a presentation ceremony.
Do you know a group or individual who has helped keep our communities connected and strong?
The nomination criteria for the 2022 Civic Awards aim to recognise groups and individuals in our district who have demonstrated service and /or leadership to help keep our communities connected and strong. This is groups or individuals who have done something that has:
- Through compassion and kindness, strengthened community connections; and/or
- Enhanced the wellbeing of vulnerable people in our community; and/or
- Created new ways to help our communities to feel safe, healthy, thriving and connected.
Completing the nomination form
We want to hear about the contributions, achievements, and special qualities of this individual or group and how they have helped to keep our communities connected and strong.

Please provide sufficient detail in the nomination form and attach supporting information or evidence to guide the panel in their decision. The panel may contact you to clarify statements in your nomination if required.

In nominating an individual or group for an award, please tell us
1. Why you have put their name/ group forward?
2. How their actions or activities have made a positive impact within Kāpiti?
3. Who was helped or benefited in a positive way? It might be your neighbours, households, hāpu, iwi and other groups.
4. Anything else you would like to share, such as stories or photos? Any other information you think would help us understand what they have achieved?
There will be a panel which will assess the merits of each nomination against the criteria and the supporting evidence in deciding who will receive the 2022 awards.

Preference will be given to people who have not received recognition in the form of a Queen’s Birthday or New Year Honours.
Nomination form
Are you nominating an individual or a group?

Individual Group
Nominee contact details
Name of individual nominee

First Name Last Name
Name of group nominee
Name of group representative

First Name Last Name
Mobile
Phone
Email
example@example.com
Website (if applicable)
Your details
Nominated by:

First Name Last Name
Nominator's email address
example@example.com
Your contact details, occupation and organisation (if applicable)
Please complete each section. You can expand on any of these by attaching additional information if you wish.
The Civic Awards recognise the efforts of people who are helping make our community vibrant, diverse and thriving. And you can tell us who you think should be recognised!
Why do you think this group/individual should receive an award?
Refer to section 'Who can be nominated' at the beginning of this form for details required.
Please use the tick boxes to indicate the criteria that you are nominating the group or individual for. Note – you may tick more than 1 criteria.

Uplifted the welfare and wellbeing of vulnerable communities Through compassion and kindness, strengthened our community Created new ways to help make our communities resilient, safe, healthy, thriving and connected
Please tell us how the individual or group has enhanced and helped the welfare and wellbeing of vulnerable communities.
Please describe how the individual or group has strengthened community connections through compassion and kindness.
Please tell us how the individual or group has created new ways to help ensure our communities are resilient, safe, healthy, thriving and connected.
Upload any additional information if you wish

Upload attachment

Cancel of
Please note how long the nominee has been a resident of the District
Privacy
The Council has a Privacy Officer whom you can contact if you have any concerns regarding privacy issues.

Personal information provided to the Kāpiti Coast District Council ("the Council"), may be held, used and disclosed by the Council:
- to enable the Council to communicate with you for any purpose
- to enable the Council to provide you, or have provided to you advice and information concerning products and services that the Council believes may be of interest to you
- to enable the Council to administer and maintain its records and carry out its required functions.
Personal information may be collected by the Council and will be held by the Council, whose address is Private Bag 60601, Paraparaumu.

You have the right under the Privacy Act 2020 to obtain access to and to request correction of any personal information held by the Council concerning you.
Privacy

I understand and agree that as this is a public award, the nominee may be contacted by Council to seek their consent to share the information in this nomination which may be used in council publications, on the website and other council communications or marketing material. Personal information will not be shared without their consent.
Your name

First Name Last Name
Date

Month Day Year
Date
If you have any questions about the criteria or completing the nomination form, please contact Margaret Sweetman, Events Coordinator at events@kapiticoast.govt.nz or 0800 486 486.
Should be Empty:

KĀPITI COAST CIVIC AWARDS 2022

Do you know a group or individual who has helped keep our communities connected and strong?

Completing the nomination form

Nomination form

Nominee contact details

Your details

The Civic Awards recognise the efforts of people who are helping make our community vibrant, diverse and thriving. And you can tell us who you think should be recognised!

Privacy