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Citizen of the Year Award Nomination

Required fields are marked with an asterisk (*).
Which category would you like to nominate
Nominee Details
Please insert the name of the person you would like to nominate
Date of Birth * This field is required for Young Citizen of the Year but also preferred for Citizen of the Year
How has this person/organisation contributed to the community?
Additional Material may be attached if required
Nominator Details
Your Name
please insert your email address
Date of nomination *