Glossopdale Community Champion Awards - Nomination Form
Please fill out this form to nominate a group or individual for an award. For full rules, guidance and privacy notice please refer to our website or contact the GCC Admin Team
1. Choose the Award that you wish to nominate for:
Choose the Award
Glossopdale Community Champion - Arts
Glossopdale Community Champion - Mental Health
Glossopdale Community Champion - Health and Fitness
Green Hero Award
The 'Outstanding Volunteer' Award
Glossopdale Unsung Hero Award
Junior Community Champion
Youth Community Champion
Young Adult Community Champion
Community Champion Group of the Year
Community Champion of the Year - Individual
Mayor's 'Lifetime Commitment to Community' Achievement Award
Reason For Nomination
*
Explain why your nominee deserves the selected award. If your nominee is a paid employee please explain your reasons for nominating them above and beyond their paid role (see 'rules and category criteria' for more information)
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2. Nominee Information (please ensure you have the nominee/parent or carers' if under 18, approval before submitting these details)
Nominee's Name
*
First Name
Last Name
Nominee's Phone Number
*
-
Area Code
Phone Number
Nominee's E-mail Address or Facebook profile link
*
example@example.com
The Nominee is aware of their nomination
Yes
No
Email or Facebook profile of the Nominee (please only enter email address if you have the nominee's permission)
example@example.com
Nominee's (please ensure that you have their permission to share this or contact the GCC Admin Team)
*
Street Address
Street Address Line 2
City
County
Post Code
3. Your Information (by submitting your details you are agreeing to being contacted if required by our Admin Team)
Your Name
*
First Name
Last Name
Your E-mail Address
*
example@example.com
Your Phone Number
*
Your Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Submit
Should be Empty: