Nomination Form


    North Perth Distinguished Women 2023 Call for Nominations

    Do you know a woman in our community who has made a difference in the lives of others by her actions….

    The nominee needs to be a resident of North Perth. Some examples of contributions could be education, health and wellness, arts, agriculture, business, community service, or any other field. Consideration will be for these categories.

    Fields with a * are mandatory.

    Please check the box for the nominee*:

     

    Why not nominate her and tell us in 200 words or less why she deserves to be included in our Women-to-Watch segment of Women United - North Perth?

    Recognition celebration to be held on Saturday, November 4th at the Listowel Ag. Hall 7:30 PM.

    By completing this form, the nominators are not related to the nominee. We would encourage all nominees to be in attendance at this event and we ask that nominators be mindful of this. Nominators will be contacted by October 27 if the nominee is being honoured.

     

    If you require assistance or have any questions please email landriessen67@gmail.com or jkgreydanus@hotmail.com.

    Confirmation of receiving this form will be sent to the first contact person shown above. Deadline is Tuesday, October 24 at midnight.

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