Civic Award Nomination | Stonehouse Town Council

01453 822070 contactus@stonehousetowncouncil.gov.uk

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Civic Award Nomination

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Please select one of the following:*

Business of the year

Community group of the year

Young person of the year

Person making an outstanding contribution to Stonehouse over a number of years

Name of person/organisation nominated*

First Last

Address*

Street Address Address Line 2 City County Postcode

Telephone number*

Reason for nomination*

Nominated by*

Address*

Street Address Address Line 2 City County Postcode

Telephone number*

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Town Hall, 1 Queens Road, Stonehouse GL10 2QA

townclerk@stonehousetowncouncil.gov.uk
contactus@stonehousetowncouncil.gov.uk

01453 822070

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