Community Awards Nomination Form
Provide nominator and nominee details, choose the award category, and describe the community impact.
Nominator Details
Full Name
*
First Name
Middle Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Relationship to Nominee
*
Friend
Colleague
Community Member
Beneficiary
Other
If Other, please specify
Nominee Details
Full Name
*
First Name
Last Name
Age
Under 25
25-35
36-50
50+
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Area/Community
*
Occupation/Role
*
Choose suitable nominee category
Please Select
1. Community Leader of the Year Award
2. Young Community Leader of the Year Award
3. Social Entrepreneur of the Year Award
4. Community Based Organisation of the Year Award
5. Best Department of the Year Award
6. Women Empowerment Award
7. Youth Empowerment Award
8. Tourism Ambassardor Award
9. Best Digital Content Award
11. Community Talent of the Year Award
Why This Person?
Describe the nominee’s community impact
*
How long has the nominee been doing this work?
*
Less than 1 year
1-3 years
3+ years
Upload a clear headshot(PHOTO) of the person you are nominating
Upload a File
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Choose a file
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of
Nominee social media link or other supporting link
Declaration
Declaration confirmation
*
I confirm that the information provided is true and accurate.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Nomination
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