Nomination Form- Nominations Close Friday 30th August 2019

Please fill out all the details to ensure your nomination is valid. All nominees either must reside in the electorate of Gembrook or actively participate in a sports club or community group in the Gembrook Electorate to be eligible for an award.

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* 1. Please fill in the contact details of the community champion you would like to nominate:

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* 2. Please outline why your nominee should receive a Gembrook Community Award. (The more detail is appreciated) 

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* 3. Please provide your information so we are able to get in touch with you regarding your nomination. (Please note without your contact information the nomination will not be valid) 

All submitted nominations will receive a confirmation email within 1 to 2 business days of submission to confirm your nomination form was successfully received.  Please ensure your contact details are correct in order for us to be able to contact you. 

The Awards will be held in Berwick on the evening of Tuesday 1st of October. Successful applicants will be notified and invitations with the events details and complimentary tickets to the Awards will be sent out accordingly after the nomination closing date.

Please do not hesitate to contact Suzannah from Brad's office on 5953 0216 if you have any enquiries.
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