Rollestonian of the Year – Nomination Form – Welcome to Rolleston on Dove Parish Council

Your Name

First

Last

Your name - not the person you are nominating.

Email or contact number

This data will only be held for the purposes of this nomination and only used if any clarification is required.

Person(s) you are nominating

Include the names of all people you are nominating or make it clear who this relates to i.e. The 'Smith family'

Reason for the nomination

Please include everything that you feel is relevant to how this person(s) has benefited the village/residents including the time period involved.

Date