Charles Rooking Carter Community Awards 2026 – Nomination Form | Puka Tono

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* 1. Your Full Name* (Required)

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* 2. Your Phone Number* (Required)

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* 3. Your Email Address* (Required)

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* 4. Name of the individual, organisation, project or business you are nominating* (Required)

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* 5. Nominee’s Phone Number

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* 6. Nominee’s Email Address (Optional)

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* 7. Briefly describe what the nominee does

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* 8. Select ONE award category

Community Spirit & Service Award – Recognises those who go above and beyond through volunteering, leadership or acts of kindness.

Arts, Culture & Heritage Award – Celebrates creative, cultural and heritage contributions, including te ao Māori values.

Environment & Sustainability Award – Honours environmental protection and sustainable living efforts.

Health, Wellbeing & Active Recreation Award – Recognises contributions to physical, mental or social wellbeing.

Youth & Future Leaders Award – Celebrates rangatahi and emerging leaders making positive change.

Long Service Award – Recognises outstanding long-term dedication and service.

None of the above

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* 9. In 100 words or fewer, why are you nominating this person or group?

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* 10. Describe the key contributions made. What did they do, and who benefited?

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* 11. Upload any supporting information

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* 12. Nominee Awareness

I confirm that the nominee is aware of this nomination or that it is appropriate for them to be contacted.

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* 13. How has the nominee shown initiative, leadership, creativity, or innovation in their approach?

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* 14. Describe any challenges the nominee faced and how they overcame them.

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* 15. Over what period of time has the nominee been contributing to this work?

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* 16. How has their involvement been consistent, ongoing, or above and beyond normal expectations?

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* 17. Has the nominee inspired others or helped build capacity within the community? How?

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* 18. Declaration

I confirm that the information provided is true and accurate to the best of my knowledge. I understand Carterton District Council may contact me if clarification is required.