Social Enterprise Partnerships

Social Enterprise Awards Nomination Form

Deadline for nominations -  30 September, 2006

 NOTE: Each Award Finalist (or a nominated representative) will be required to attend
the Social Enterprise Awards Dinner to be held on 16 October, 2006 in Melbourne.

           Name of person making the nomination

Name
Title
Organisation
Work Phone
FAX
Email
 

 Address

  

 Address
City
State
Postcode
Country

          I am a

             

          My nomination is



from



Award Category



Rationale (maximum - 200 words)




Are you willing to be contacted by the Selection Committee about this nomination?

                   

          PRIVACY STATEMENT:  Your details will be held in the strictest confidence and
          will not be passed to a third party.

          Social Enterprise Partnerships Ltd
          ABN 47108742098
          2 Elm Street
          North Melbourne
          Phone (03) 9326 4481
          Fax (03) 9326 8030