NOMINATION FORM
Please note: nominations close 5pm on Sunday 22 September 2024
ELIGIBILITY AND CATEGORIES OF AWARDS
Your details (nominator)
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you happy to be identified as the nominator?
YES/NO
Nominee details
Volunteer information
Preferred Title/Pronouns (if applicable)
TITLE eg. DR, Mr, Mrs, Ms, Miss
PRONOUNS - He/His, Her/She, They/Them
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list the organisation/s the Nominee volunteers for:
*
List as many as relevant
Has this nominee/s been a previous recipient of these awards?
YES/NO
CATEGORY FOR NOMINATION
*
Youth (under 24 years)
Emergency Management
Group
Inspiring Individual
Member of Parliament
How did you hear about the Wannon Volunteer Awards?
Please Select
Previous award winner
Email
Social Media
Newspaper/Radio
Word of mouth
Other
REASON FOR NOMINATION
*
In approx. 100 words, please describe why you nominated this person/team/organisation
KEY ACHIEVEMENTS OF THE NOMINEE
*
Eg. Fundraising figure, roles held and timeframes, other notable recognitions, volunteering history
KEY ATTRIBUTES OF THE NOMINEE
*
Eg. Leadership, commitment - please refer to the elibility criteria
YEARS OF SERVICE
*
Submit
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