Wychavon Community Stars nomination form

Nomination form
To make a nomination for a Wychavon Community Star please complete and submit this short form.

You do not need to complete the form in one go. You can save it at any time by using the save button at the end of the form.

If you wish, you may include any other evidence you have to support your nomination, for example articles, photos or letters. You can upload this at the end of the form.

If you prefer you can email supporting evidence to tracy.perkins@wychavon.gov.uk. Please title your email: Wychavon Community Star supporting evidence [insert the name of the person/organisation you are nominating].

Once you have completed and checked the form click the submit button.
1. Your details
Your name*

First nameLast name
Address*

Street Address

Street Address Line 2

Town / villageCounty

Postcode
Email
example@example.com
Phone*
2. Nominee's details
Who are you nominating? You can't nominate yourself.*

An individualA group or team of peopleAn organisation
Name of person / people / organisation you are nominating*
Address

Street Address

Street Address Line 2

Town / villageCounty

Postcode
Email
example@example.com
Phone
Is your nominee under 18?*

YesNo
So you have relationship with or are you a member of this organisation?*

YesNo
4. Reasons for your nomination
Please explain in a minimum of 150 words why your nominee deserves a Wychavon Community Star. You can tell us as much as you like about them. The most important thing is to provide evidence of what they’ve done and how they’ve made things better for others. Please read the guidance on our website so you know what we are looking for.*

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5. Additional evidence
Provide the name and contact details for a person or organisation who is willing to second this nomination. Please make them aware we may get in touch with them about the nomination. *
Name
Email
example@example.com
Phone
Are you submitting additional evidence of your nominee's contribution?*

YesNo
If you are submitting any additional evidence to support your nomination, for example articles, photos or letters, please list them here and upload them below .
Please upload any additional evidence to support your nomination.

Cancelof
6. Declaration
Please tick the box below to indicate that to the best of your knowledge that all the information you have provided on this form is truthful and correct at the time of submission.*

YesNo
We will share your nomination form with Wychavon officers and copies with personal data (names and contact details) removed with councillors and members of our Communities and Funding Advisory Panel. We will share the form for the purposes of carrying out due diligence and assessing the nomination.

We will hold, process and store your information and your nominee's information in accordance with Data Protection Law. For more information please see our privacy notices on our website.
Should be Empty:

Nomination form

1. Your details

2. Nominee's details

4. Reasons for your nomination

5. Additional evidence

6. Declaration