Online Form - "Bassendean means Business" Award

Presented to a business operating within the district that has made a positive community impact, shown significant business agility, provided outstanding customer service or proactively contributed to environmental sustainability in their business practices and/or in the community.

About the business you are nominating:

Please tick the boxes below to show that your nomination meets all the following criteria:*

This business operates in the Town of Bassendean.
I am not the owner of the business being nominated.
I understand the assessment of the nominee will be made based on the information that I provide in this application.
I understand that a copy of this application will be shared with the Nominee.
I have read and agree with the Terms and Conditions.

Name of Business (One Business Only)*

Name of Contact Person

Address

Street Address:

City:

State:

Post Code:

Country:

Phone Number*

Email Address*

Reason for nomination:

How has this business made a positive community impact, shown significant business agility, provided outstanding customer service and/or proactively contributed to environmental sustainability in their business practices?*

Please provide your details:

In this section, please describe clearly and concisely why the nominated business should be recognised. Tell us what you think is noteworthy and how this business:

Your Name*

Address

Street Address:

City:

State:

Post Code:

Country:

Phone Number*

Email Address*

Where did you hear about these awards?*

Terms & Conditions

Thank you for taking the time to complete your nomination.

Please accept the Terms and Conditions to continue:

Acceptance*

I have read and agree to the Terms and Conditions in the link above

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