Excellence in the Community Awards 2010

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Nominee
Name of Nominee:
Address Line 1:
Town:
Post Code:
Telephone (Day):
Telephone (Evening):
Has the person being nominated had a permanent home or work address in the Down District Council area for the last 12 months preceding submission of the nomination?:	YesNo
Nomination
This nomination has been submitted by::	SelfOther
(If other, please give your name, address and telephone number below):
Name:
Telephone:
Address:
Category of Nomination
Please tick the category for your nomination:	Outstanding Bravery Child / Teenager of Courage Local Champion Emergency Services Teacher of the year Fundraiser of the Year Lifetime Achievement Special Recognition
Please use this space to tell us why your nominee deserves a Down District Council Excellence:
I agree that all the information contained above is correct:	YesNo
Please send a supporting photograph of the person being nominated to: marketing@downdc.gov.uk:

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