Community Champion Campaign Form

The Community Champions Campaign is the Shire’s volunteer recognition program. Identified as a community priority in the Council Plan 2022-32, the Community Champions Campaign recognises volunteers at the heart of our community and spotlights a local volunteer for delivering positive impact in the community. It also raises the profile of volunteering and the diverse opportunities available.

Nominate a Community Champion today!

Nominator's Name

Phone Number

Email Address

Nominee's Name

Nominee's Phone Number

Nominee's Email Address

Upload a Photo of the Nominee

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Name of organisation(s) nominee is engaged as a volunteer

Briefly describe why this individual has been nominated (include duties carried out, how they have benefitted the organisation and the wider community)

Community Champion Campaign Form

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