Young Citizen of the Year 2023

The Rotary Club of Southern Districts Is seeking Nominations for this award

Nominator

Please enter the name and contact details for the person nominating the candiate.

Name*

Address*

Phone Number*

Email Address*

Nominee

Please enter the personal details for the person you are nominating for this award.

The nominee must be under the age of 21 in the year of the award.
The nominee must be a resident in the City of Gosnells for at least three years.

Name*

Address*

Phone Number*

Email Address*

Date of Birth*

Resided in City of Gosnells for 3+ Years*

Upload Application

Please upload a document (Microsoft Word or PDF) containing the nomination. Please provide as much relevant information as you can to support the nomination. There are no specific content requirements, but examples include:

Specific activities conducted by the nominee that have benefited the community,
Participation in volunteer and community activities,
Academic or vocational achievements,
Participation and contributions to local sporting, social or other community groups,
Anything else that you believe demonstrates their ongoing contribution to the community.

Note: the document must be in either Microsoft Word or PDF format.

Upload Applicant Information*