You are on page 1of 2

Community Achievement Awards 2013

Nomination Form
Do you know an individual or group who has made a special contribution to the community in
County Monaghan? Would you like to see their efforts recognised by nominating them for a
Community Achievement Award?
I wish to nominate:

Award Categories:

Name of Group or Individual

*Please select the award you are nominating the individual or


group for from the list below:

___________________________________________
Getting People Involved
Volunteer of the Year

Address: ____________________________________

Neighbour of the Year

____________________________________

Community Health Initiative

____________________________________

Community Fundraiser of the Year


Event of the Year

_____________________________________
Tel:

_____________________________________

Festival of the Year


Young Community Leader (s)

Reason for Nomination (Why do you believe this person/group deserves this ward)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Telephone/Mobile Number: ____________________
______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_____________________________________________________________________________________________
_______________________________________________________________________________________________
*Please
attach additional sheets if needed
_______________________________________________________________________________________________
____________________________________________________________________________________________

Monaghan Integrated Development


Supporting Growth and Opportunity

How have they made a difference?


_______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

*Please attach additional sheets if needed


Entries to be posted to:
Regina Byrne
Community Development Officer, Monaghan Integrated Development, The Workhouse, Shercock Road
Carrickmacross, Co Monaghan
Entries can also be e-mailed to rbyrne@midl.ie
Closing date for receipt of entries is Friday 4th October 2013

The Community Achievement Awards ceremony will take place on Monday 21st October 2013 at 8 pm in the Iontas
Centre, Castleblayney.

Monaghan Integrated Development


Supporting Growth and Opportunity

You might also like