Community Champion 2024 Nomination form

Nominations for the Pat Eastop MBE Junior Citizen of the Year Award, Volunteer of the Year Award, Community Group of the Year Award, Lifetime Achievement Award.

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4. Unique Reference Number
Criteria
1. Nomination criteria for the awards are available on the Community Champion Award Scheme webpage. Please ensure that you have read the criteria before completing your nomination form as the criteria will be used to by the independent judging panel. You may also find the ‘hints and tips’ section helpful when completing your form.
2. The closing date for nominations is Monday 11 November 2024.
Nomination for*
1. Pat Eastop MBE Junior Citizen of the Year Award
2. Volunteer of the Year Award
3. Community Group of the Year Award
4. Lifetime Achievement Award
1. Nominee Details
2. Nominated Group Details
3. Name
  1. Title
  2. Other Title
  3. First Name*
  4. Last Name*
4. Nominee's Age
  1. Age*
  2. Must be 18 or under
6. Address
  1. Postcode*
    
    Address
9. About the Group
  1. Group Name*
  2. Number of members in group
  3. Purpose of group
10. Contact Details
  1. Email
  2. Telephone / Mobile
11. 1. Please note that the nominee should live within West Berkshire, or their contribution should be of benefit to the residents of West Berkshire, to be eligible for this award.
  2. Please note that the Nominee Group must be based within West Berkshire, or providing a service to the benefit of West Berkshire residents, to be eligible for this award.
1. * Please correct any of the validation issues highlighted above

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Community Champion 2024 Nomination form

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