Derby Youth Awards 2021 Nomination Form

Nominated Young Person's Name *

First

Last

Nominated Young Person's Age *

Must be between 10 and 25.

Which category are you nominating the young person for? *

Please describe your relationship with the young person(s) and how long you have known them. *

Please describe why you are nominating the young person/people for this award? *

What do you think that the recognition from this award would mean to the young person/people? *

Nominated Young Person's Phone Number (If aged under 18, please use a parent/guardian's phone number) *

Please note that this will only be used in the case that your nominated young person is successful.

Nominated Young Person's Email (If aged under 18, please use a parent/guardian's phone number) *

Please note that this will only be used in the case that your nominated young person is successful.

Your Name *

First

Last

Your Phone Number *

Please note that this will only be used in the case that your nominated young person is successful and cannot be contacted using the details provided for them.

Your Email *

Please note that this will only be used in the case that your nominated young person is successful and cannot be contacted using the details provided for them.

Are you happy to be contacted about other opportunities that Sporting Communities offer? *

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