Your Nomination Details

* Indicates required information

Closing date for receipt of nominations: 31 March 2010.

Please read the entire nomination form before completing it. Please take a copy of the completed form for your records.

Name (nominator):

Association:

Contact address:

Tel. (day):

Mobile:

Email address:

My nomination is for the following award/trophy:

I agree to CSSC using information in my nomination for educational or promotional purposes.

Date:

Conditions of entry

1. All individual nominees must be CSSC members. 2. Relevant additional information cannot be returned - please submit copies if necessary. 3. The judging panel's decision is final andno correspondence will be entered into.