SOLIDAR Silver Rose Awards 2013 Nomination Form

4. Contact Information
In the next section, please provide details of a) the person/organisation being
nominated 1 and b) your own contact details. We will contact the
person/organisation nominated and your name will not be made public.
a) Person/Organisation being nominated
Name:
Organisation:
Address:
Telephone:
Email:
Fax:
Website:
b) Your Contact Information
Name:
Organisation:
Address:
Telephone:
Email:
Fax:
Website:
1 It is compulsory that you send us the full contacts details of the nominee. If we do not receive these, the nomination will be
disregarded.
Nomination Form Silver Rose Awards 2013 5