Online Form - Community Inclusion Award

This award will be presented to a local community group, club, business that has implemented a successful program or initiative that has facilitated the inclusion of diverse groups within the wider Bassendean community. This includes but is not limited to the initiatives that support the inclusion of mental health consumers, people with disability, Aboriginal & Torres Strait Islanders, CaLD communities, LGBTQIA and/or Seniors.

About the Organisation you are nominating:

Name of Group *

Name of Contact Person

Address *

Phone Number *

Email Address *

Nomination details:

How has this group serviced the Town of Bassendean and implemented a successful program or initiative that has facilitated the inclusion of diverse groups within the wider Bassendean community? *

How has the organisation built capacity, connection and sense of belonging and contributed to an empowered community? *

Please provide your details:

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:

Terms and Conditions

Acceptance *

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

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