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🏆 Broxtown Community Champion Nomination Form

Thank you for taking part in the Broxtown Community Champion Awards - celebrating the incredible people and groups who make a real difference in our community. 🌟

Please complete the form with your details and those of your nominee, and select the Award Category that best fits their contribution. You can nominate for any of the award categories, but only one per submission.

The more details you share, the better we can highlight their story and impact. đź’¬
All information will be handled in line with GDPR and used only to manage nominations and contact you about your entry.

First name

Last name

Email

AWARD CATEGORIES

Name of Nominee (full name)

Nominee Email

Nominee mobile

Where do they live?

Why are you nominating him/her?

How have they made a difference?

How long have they been involved in the community?

What's your connection to the nominee? (e.g., neighbour, friend, colleague):

Do you have a photo of the nominee in action? (Attach if possible)

Additional information