Nomination Form

Make your nomination for
’Individual Making a Difference in the Community’ by completing the form below.

  • Your Details

  • This is the title that will be used on the website and
    presentation on the night should you be shortlisted.
  • Your Nomination

    This award is aimed at highlighting an individual who has made a significant positive impact within the local community, socially, culturally & economically. The individual can be within an organisation or stand alone.

    Judges will be looking to recognise dedication to volunteering efforts, organised fund-raising initiatives, supported individuals or communities through challenging situations, or /and giving back through various initiative: i.e.: community-based projects and / or services that have supported the regions communities.

  • Supporting Files

  • Accepted file types: jpg, png.
    (JPG or PNG, Max 2MB)
  • (Max 10MB)
  • (Max 10MB)
  • (Max 10MB)