Quality of Life Award Nomination Form
Nominate an individual or group who has made a significant impact on quality of life. Please provide detailed information to support your nomination.
Your Full Name
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First Name
Last Name
Your Email Address
*
example@example.com
Nominee's Full Name
*
First Name
Last Name
Nominee's Role or Relationship to the Community
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Category of Nomination
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Please Select
Health & Wellbeing
Community Service
Education & Learning
Environmental Improvement
Innovation
Other
Describe why you are nominating this individual or group. Please include specific achievements or contributions that have improved quality of life.
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Additional supporting information or examples (optional)
Submit Nomination
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