Nomination Form

Closing date for nominations 31 March 2011

Your Details

Name ……………………………………………………………………………………………….

Address ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Telephone………………………………………………………………………

Email address (optional)……………………………………………………………………

Name of the Individual or Group you wish to nominate

………………………………………………………………………………………………………….

Please use the page overleaf, and continue on a separate sheet if necessary, to describe in not more
 than 250 words the activity/ achievement for which you are making the nomination.

Please return completed forms to Chapel-en-le-Frith Parish Council, Town Hall, Market Street,
 Chapel-en-le-Frith, SK23 0HP,

marked ‘Community Awards’ or email to:

clerk@chapel-en-le-frithparishcouncil.gov.uk

To download a nomination form visit:

www.chapel-en-le-frithparishcouncil.gov.uk

 and look at the Community Award page