Volunteer Acknowledgement: Nomination Form

Volunteer details

Name

Phone

Address

Is the volunteer/organisation based in the Litchfield Municipality?

Yes

Organisation, group or community activity they volunteer with

If they volunteer independently, please tell us what they do.

What does this person do as a volunteer?

Tell us about their usual tasks, the people or activities they support, and any other roles they take on.

How often do they volunteer?

ie. weekly, fortnightly, monthly, seasonally, other. Please elaborate where relevant.

Approximately how long have they been volunteering in this role or community?

What difference has their volunteering made?

You might share a particular example, explain who benefits from their help, or describe what people value about their contribution.

Please include any additional documentation to support your nomination

eg. Letter of Support, photos at event, etc.

Maximum 5 files.
20 MB limit.
Allowed types: pdf, doc, docx, odt, ppt, pptx, jpg, jpeg, heif, heifs.

Nominator (your details)

Name

Phone

Address

City/Town

Before you submit

I believe this person’s volunteer contribution has taken place on multiple occasions or recurs across seasons or years. The information I have provided is accurate to the best of my knowledge.