HomeCommunityActive Blackpool Community AwardsActive Blackpool Community Awards Nomination Form

Active Blackpool Community Awards Nomination Form

Your Name

First

Last

Phone Number

Name of your Nominee

First

Last

Email of your Nominee

Phone Number of your Nominee

Please select the Award you are making the nomination for

Tell us briefly why you are making this nomination

What impact has the person/group had on others

If they've had any barriers to overcome, let us know a little more about them

Tell us about what they have achived this year

If you have anything else you want to share with us about your nomination, please let us know more.....

If you have any images, videos or other evidence to support your nomination, please upload it here.

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.