For office use only:

Date received / Nomination Number / District

THE HIGH SHERIFF’S AWARDS

SUFFOLK LIFETIME ACHIEVEMENT AWARD 2017

Nomination Form

The High Sheriffs’ Lifetime Achievement Award encourages voluntary organisations, charities and community groups across Suffolk to nominate one of their volunteers for special recognition of their services and commitment over many years. The award consists of a trophy for the winning volunteer and a cash award for his or her voluntary organisation, charity or community group.

We hope you will find this form quite easy to complete, but if you have any questions, please call Hollie Martin on 01473 786914. Please return your completed, signed form to: Suffolk Community Foundation, The Old Barns, Peninsula Business Centre, Wherstead, Ipswich, Suffolk IP9 2BB. We also greatly appreciate receiving an electronic copy of the application, so if possible please also email the application to

The deadline for nominations is 26th January 2017

About the volunteer you are nominating

Name of nominated volunteer:

Contact address for nominated volunteer:

Address Ln1
Address Ln2
Address Ln3
City/Town / Postcode
Main phone / Mobile
E-mail


Why are you nominating them for a Lifetime Achievement Award (in less than 250 words please):

About you

How do you know the volunteer you have nominated (in less than 250 words please):

Your name:

Your contact address:

Address Ln1
Address Ln2
Address Ln3
City/Town / Postcode
Main phone / E-mail
Mobile

I give permission for Suffolk Community Foundation to record the information in this nomination electronically.

Signed / Date

Last question

Where did you hear about The High Sheriff’s Awards and Suffolk Community Foundation?

The High Sheriff’s Award Ceremony will take place on Thursday 23rd march, 2017 at Snape Maltings. Shortlisted nominees will be contacted a couple of weeks before the ceremony.

The High Sheriff’s Suffolk Lifetime Achievement Award has been kindly sponsored by Whiting & Partners.

Suffolk Community Foundation administers The High Sheriff’s Fund and we work in partnership with The High Sheriff of Suffolk in organising the High Sheriff’s Awards.

Suffolk Community Foundation is a registered charity (1109453) and a company limited by guarantee (5369725).

Suffolk Community Foundation Page 3 of 3 Issue 2015