2023 COMMUNITY GROUP OF THE YEAR NOMINATION FORM

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Name of Organisation

Organisation's Contact 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

Description of the Organisation

Describe the Organisation's contribution to the Peel Communuity

How long has the Organisation operated in the Peel Region?

Please provide the name of an independent referee

Phone number of independent referee

Email of independent referee

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

Please upload the organisations logo

Click or drag a file to this area to upload.

Name of person making the nomination

First

Last

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