Address:

Postcode:

Email: (We will only contact you by this email address regarding Gold Star awards and not for any marketing purposes.)

Organisation/Charity/School (if relevant):

Your daytime telephone number:

Nominee Details:

I would like to nominate the following for the Gold Star Awards 2009-2010

Their name:

Their Address:

Their Postcode:

Their daytime telephone number:

Organisation/Charity/School they represent (if applicable):

Describe why you think the above named person deserves a Gold Star award.
Please cover areas such as: What it is they have done? Why this person is an inspiration to others? Why do they deserve special recognition?