NOMINATION FORM Survey

1.What award category are you nominating to? (Tick only one category)(Required.)

Youth Achievement
Recognising achievement by an individual (under 25 years old) or project involving young people which has made a positive difference in the community

Education and Learning
Positive impact of school based approaches or organisations and projects helping learners of any age and all types to achieve their full potential

Sport and Physical Activity
The role of sport and physical activities in building confidence, bringing people together or improving health and well-being

Celebrating Diversity
Activities which improve relationships between and within communities; connect people from diverse backgrounds or build understanding of different cultures and beliefs

Creativity and Innovation
Using arts, creativity and other innovative approaches to help communities to work together to tackle social challenges and community issues

Thriving Places
Buildings, meeting places or projects involving innovative design or use of public spaces which bring residents and visitors together in shared and safe places and provide focal points for improving community confidence and pride

2.Which Urban Village area? (Tick only one)(Required.)

Ardoyne and Greater Ballysillan (North Belfast)

Sandy Row, Donegall Pass and the Markets (South Belfast)

EastSide (incorporating the lower part of the Newtownards Road in East Belfast)

Colin (covering Poleglass, Twinbrook, Lagmore and Kilwee in West Belfast)

Bogside, Fountain and Bishop Street (Derry~Londonderry)

3.Who or what are you nominating?
Provide appropriate contact details (if known) for the nominee. Ensure they are eligible for nomination. This means individuals or people living or working within the area; or an organisation, place or project based in and/or serving the community in the Urban Village area

(Required.)

1.Name/Organisation

2.Email

3.Project title

4.Why should this nominee be recognised with a Community Award in this particular category? (maximum of 500 words)

Tell us what they did.
Tell us how well they did it.
Tell us about the difference it made.
(Required.)

5.Are there any other partner organisations involved?
Any collaborating organisations within the Urban Village area or from other places? Or links to other programmes or funders? This doesn't have to be the case but if so, please provide some details.

6.In case we need to contact you
Tell us your name, organisation (if appropriate) and contact details
(Required.)

Name

Organisation

Telephone

NOMINATION FORM

Celebrating the people, organisations and places making a difference in Urban Village areas