12 Stars of Eden
Please submit your chosen nominee to be considered as one of the 12 Stars of Eden by answering the following questions:
What is your name?
*
First Name
Last Name
What is your email address?
*
example@example.com
What is the name of the person you are nominating?
*
Full Name
Is the person you are nominating local to High Wycombe?
*
Yes
No
What is their role?
*
e.g. a teacher, hospital staff, local volunteer etc
What is your relationship to this person?
*
e.g. my dad, my teacher
Why are you nominating this individual? (Max 150 words)
*
0/150
What is the email address of the person you are nominating?
*
example@example.com
What is the phone number of the person you are nominating?
*
-
Area Code
Phone Number
By registering for this event you agree to our data privacy statement and to receive our email newsletters. You can unsubscribe at any time by following the link at the bottom of our emails.
*
I agree
Date
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: