Online Form - Outstanding Person with a Disability 2024 - Nomination Form

Do you know someone living with a disability who deserves recognition for their outstanding personal achievement in the past 12 months?

Nominator Name (name of the person nominating):*

Nominator Phone*

Nominator Email*

<br>Award Category*

Age (12-24 years)Age (25+)

Nominee Full Name (name of the person being nominated):*

Nominee Address*

Nominee Phone*

Nominee Email*

Nominee Date of Birth*

Describe how the individual has worked towards and/or achieved specific milestones in any area in the past 12 months.*

Any additional documents

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