Community Citizenship Nomination Form

Nominee/s must have been carrying out their good work to be valid.

Please note: Nominations are restricted to one entry per school.

To nominate for the Community Citizenship Award please fill in the form below.
This is an online form so please ensure you have filled out the required fields.

Please review your submission thoroughly prior to pressing “Submit.”

A copy of the form will be sent to us via email, there is no need to print-off and send in.

The Nominee/Team MUST agree to this nomination being made and for their information to be disclosed for this purpose.
PART 2 - INFORMATION ABOUT THE STUDENT/TEAM NOMINATED
If individual nomination please insert n/a
Limit of up to 20 team members only. If individual nomination insert 1
List full name of all team members. If individual nomination please insert n/a
If individual nomination please insert n/a
If applicable
PART 3 - INFORMATION ABOUT THE NOMINATOR
PART 4 - INFORMATION ABOUT THE NOMINEE/S
What does the nominee do?
What the nominee achieves through their work
PART 5 - STATEMENT FROM THE STUDENT
PART 6 - CHARITY/ORGANISATION
Name of Charity or Organisation for Donation
Media & Information Release
The nominee must agree to their image and story being used publicly by Wests Ashfield to promote the Community Citizenship Awards