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Cathaoirleach’s Community Awards 2020 – Individual
Galway County Council
The Cathaoirleach’s Community Awards 2020
Please read the
accompanying terms & conditions and judging criteria linked below before completing the form
Guidance Notes:
Cathaoirleach_Community_Awards_2020_Guidance_Notes
Nomination Form for Individual Volunteer of the Year
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Please state the name of the Individual who is being nominated:
*
This form should be used to nominate an Individual in recognition of their significant contribution to Community & Voluntary life in County Galway. Please read the accompanying terms & conditions and judging criteria before completing the form.
DETAILS OF INDIVIDUAL BEING NOMINATED
Name of Individual being nominated:
*
First
Last
E-mail address:
*
Telephone No.:
*
Is the Individual a member of a PPN Registered Group in the County?
*
Yes
No
Don't know
Name of Group:
What community/parish does the individual cover in their voluntary work?
*
For background purposes, please describe how this Individual has engaged with the local community over the years in the course of their voluntary work and outline their main achievements:
*
Please describe the voluntary work of the Individual in 2020 and how it has benefited individuals and the wider community:
*
Explain why you think the Individual deserves to win a Volunteer of the Year Award:
*
Please provide links to any supporting documentation regarding their activities in the community:
*
DECLARATION OF NOMINATING GROUP OR THIRD-PARTY INDIVIDUAL:
Name of Group or Third-Party Individual making the nomination:
*
E-mail address:
*
Telephone No:
*
What is your link/relationship to the Individual you are nominating?
*
I declare that the information given in this form is true and complete to the best of my knowledge and agree to the processing and disclosure of information by Galway County Council and Galway County PPN to other third parties for the judging process, and further consent to the disclosure of relevant information by these parties relating to the marketing or promotion of the Awards. I confirm that the Nominated Individual is aware and in agreement with their nomination for the Awards and agree to accept the decision of the judging panel for the nominations as final. Signed on behalf of nominating Group or Third-Party Individual:
Name (in block capitals):
Email Address: (in case further contact is required to clarify details)
*
Signed:
Group / Organisation:
*
Date
*
Day
Month
Year
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