Nominee Details The name of the individual or event being nominated *
(The person or event you would like to nominate)
Nominee's Address (person, group or organisation being nominated)
* Nominee's Phone No. * Nominee's Email
I/We nominate this individual/Group or Organisation for the following award category * In what area(s) has the nominee excelled? (For Community event please skip to Events Questions) How have they contributed to the local government area of Devonport (including volunteering)? * What makes them an inspirational role model? * How does the event address the selection criteria below? (For Citizen or Young Citizen, please skip to supporting documentation) The quality of the event: The scope of impact the event has on the local government area: The event's contribution to the community: Please attach any supporting documentation for your nomination Accepted file types: png, jpg, pdf, gif, word.
Upload File 1 (Please note only PDF, Word Doc, png, Docx or JPEG files will be accepted)
Please attach any supporting documentation Accepted file types: png, jpg, pdf, gif, word.
Upload File 2 (Please note only PDF, Word Doc, png, Docx or JPEG files will be accepted)
Nominator's Details Nominator's Name (Name of person making the nomination) *
(Name of person making the nomination)
* Nominator's Phone No. * Nominator's Email *
Is your Nominee: * Referee Details Referee's Name *
Referee's Phone No. * Referee's Email
This field is for validation purposes and should be left unchanged.