* 1. Who is the individual you are nominating for this award?

* 2. What has the individual done for the benefit of the community?
(no more than 120 words)

* 3. Why have they done this?
(no more than 120 words)

* 4. How has this improved the community?
(no more than 120 words)

* 5. What is the long lasting effect?
(no more than 120 words)

* 6. Your contact details

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