Making a Difference Awards 2019 Resident Nomination Form OK ABOUT YOU OK Question Title * 1. What is your name? OK Question Title * 2. What is your address? OK Question Title * 3. What is your phone number? OK Question Title * 4. What is your email address? OK ABOUT THE PERSON OR GROUP YOU ARE NOMINATING OK Question Title * 5. What is the name of the person or group you are nominating? OK Question Title * 6. What is the address of the person or group you are nominating? OK Question Title * 7. What is the contact telephone number of the person or group you are nominating? OK Question Title * 8. What is the email address of the person/group you are nominating? OK Question Title * 9. What is the age(s) of the person/group you are nominating? OK Question Title * 10. Is the person or group you are nominating a Wales & West Housing resident? Yes No Unsure OK Question Title * 11. Photographs are to be submitted to awards@wwha.co.uk or please supply them on a disk/memory stick to the PR & Comms Team ASAP.I have submitted a photograph(s) Yes No OK Question Title * 12. Which category are you nominating them for? Good Neighbour Going Green Wellbeing Champion Bridging the Gap Fresh Start Community Heroes Fundraising Champion Outstanding Achievment OK Question Title * 13. What has this person/group done to deserve an award? (Please describe what they have done for you and/or your community that makes them stand out from others, giving examples where possible. For example, what was the situation like before? 100 -250 words max) OK Question Title * 14. How has their action made a difference to you, your neighours and/or your community? (Please give examples where possible, tell us about the impact their actions have had on their lives and those of the people around them and/or the wider community 100 -250 words max) OK Question Title * 15. Why do you think this person or group should win? What have they done that goes beyond? Have they overcome any barriers to get where they are? What challenges did they face and how did they succeed? 100 -250 words max) OK Question Title * 16. Please give any comments or feedback from others in the community to support the nominee. (comments 100 - 250 words max) OK Question Title * 17. Is there any of the information that you have given above that you would not want publicised or mentioned during the awards ceremony or in promotional materials? If so, please specify below. OK Nominations close on Friday 16 November 2018 OK DONE