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* 1. Name of person you are nominating:

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* 2. Name of the school they are currently involved in:

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* 3. Are you nominating this member for:

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* 4. How long has this person been working on Move Well Eat Well (if you know)?

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* 5. Please select the following activities this person has been involved in:

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* 6. In three to five bullet points describe how this person has led Move Well Eat Well in your school/at their previous school/s?

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* 7. What are this person’s key qualities that make them an effective Move Well Eat Well Leader?

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* 8. Your name (optional)

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