Nomination form

Thank you for taking an interest in being a nominee in this years' Environment Southland Community Awards. To complete the nomination form you must first register with this site. 

Click here to register.

Answer each question and provide as much information as you can. You can save at the end of each page (there are only 3) and come back and complete it at a later date.

Once submitted, we will be in touch to arrange a judges visit. Please call 0800 76 88 45 if you have any questions about the nomination process or other aspects of the awards.

You need to be signed in to take this survey.

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Award categories

Enter a maximum of two categories. The judges reserve the right at their discretion to consider a nominee in a different category, if they deem that to be more appropriate

Options are limited to 2
Options are limited to

Nominee information

Maximum characters 255
Maximum characters 255
Add a contact name if the nominee name is a school, business, farm etc.

Nominator information

Please provide your contact information if you are completing this nomination on behalf of the nominee.

Maximum characters 255
Please hold on while your response is being submitted