Group nomination form
Nominator Information
Contact information for you, the person nominating
Nominator Name
*
First Name
Last Name
Nominator Organisation
Nominator Email
*
example@example.com
Nominator Phone Number
*
-
Area Code
Phone Number
Nominator Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee Information
Contact information for the group you are nominating
Nominee Name
*
Nominee Email
*
example@example.com
Nominee Phone
-
Area Code
Phone Number
Nominee Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nomination
Please ensure that the group you are nominating are aware of your nomination. A copy of this nomination will be automatically emailed to them.
Nomination Summary
*
Provide a short paragraph about your nominee (which we may use for publicity purposes with their permission)
Are travel expenses for the group representatives required?
*
No
Yes
Are you able to sponsor travel expenses for your nominees?
*
No
Yes
Raising Awareness
How has the group or organisation raised awareness of violence against women and how has it tried to bring about change?
Challenges
How has the group or organisation overcome any obstacles in its way?
Innovation
How has the group or organisation shown originality or innovation in the way it does its work?
Successful
How has the group shown that its work is successful?
Strategies
What particular strategies has the group or organisation used to make sure it is successful?
Current Funding
Does the organisation currently get funding? If so, where from?
Impact of the Award
How will the award help the group or organisation in the future?
Other relevant information
Any other relevant information
Submit
Should be Empty: