2023 Nomination Form - Individuals & Youth

Which category are you entering?

Peel Volunteer of the Year
Peel Youth Volunteer of the Year

Volunteers Full Name (Person being nominated - Nominee)

First

Last

Nominee's Contact Phone

Nominee's Email

Nominee's Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Organisation Nominee Volunteers with:

Organisation's Phone

Organisation's Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Organisation's Email

Organisation's Contact Person

First

Last

Does the Nominee volunteer with any other organisations?

Yes
No

If yes, please provide the name of the Organisation

Describe the Nominee's contribution to your organisation

How long has the Nominee volunteered in your organisation?

What is special about this Nominee?

How has the contribution of this Nominee benefited the Peel Community?

Please provide the name of an independent referee

Phone number of independent referee

Email of independent referee

I certify that the Nominee has agreed to be nominated and, if they are a finalist, their name and photos can be used in media releases and publicity

Yes
No

Please upload a photograph of the Nominee (.jpg .bmp or .jpeg)

Click or drag a file to this area to upload.

Name of person making the nomination

First

Last

Organisation nominator belongs to

Nominator's Phone

Nominator's Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Nominator's Email

Signature (please enter your name as a signature)

Date

2023 VOLUNTEER AND YOUTH VOLUNTEER OF THE YEAR

NOMINATION FORM