SIMBA- EXCELLENCE GALA

SIMBA- EXCELLENCE GALA

Application for Nomination
APPLICATIONS CLOSE ON 15TH FEBRUARY 2024
Community Services

Criteria- The Community Services Excellence Award is designed to recognize and honor outstanding contributions to community service. 1) Impact on Community 2) Innovation and Creativity 3) Dedication and Commitment 4) Leadership and Inspiration

2. Nominee Information
Nominee's Name

First NameLast Name
Nominee's Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Nominees Ethnicity
Nominee's E-mail Address
Nominee's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

3. Your Information
Your Name

First NameLast Name
Your E-mail Address
Your Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reason for Nomination (Min 50- 200 Words)
Please provide examples
Please provide supporting documentation (this can be photos, copies of awards, references etc.)
File Upload

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DOCUMENTS REQUIRED & CHECKLIST

Before sending your application, please ensure all fields have been entered correctly. Incomplete applications will not be processed Copy of Business Registration Certificate is attached.Two photos that highlight the goods and/or services produced by the business are attached.All sections of the nomination form are completed.Declaration section is signed.Copy of the nomination form is retained for your records.
DECLARATION

The declaration must be signed for the nomination to be processed.
I understand that the submission of a nomination form does not guarantee

Business Award and the decision is at the discretion of the judging panel.

1.By completing this form, , I acknowledge that I have read and understood the Business Awards’ Terms and Conditions.

2.By submitting this form, I agree to adhere to the requirements as set out in the Business Awards’ Terms and Conditions.

3.I hereby certify that:
a)The information supplied in this nomination form is correct to the best of my knowledge. I also undertake to advise Sydney Community Group should there be any alterations or additions to the information supplied at the earliest possible date.
b)The nominated business does not have any outstanding orders, notices, legal matters, debts or complaint investigations
c)The nominated business must be able to provide copies of appropriate certifications as stated.

4. I consent to photographs supplied in this Nomination Form and any photographs taken of
the business including its employees, being used by Sydney Community Group for promotional, marketing material and website.

5. The nominator should consent with the nominee before applying he/she for nominations.
Signature

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SIMBA- EXCELLENCE GALA

Community Services

Reason for Nomination (Min 50- 200 Words)

Please provide supporting documentation (this can be photos, copies of awards, references etc.)

DOCUMENTS REQUIRED & CHECKLIST

DECLARATION