Nomination Form


Complementary Schools Celebration Event

Nomination Form

Complementary School Details

Name of Complementary School

Membership Number

Contact Name

Email Address

Contact Number

Staff Nomination

Please nominate one member of staff

Name

Reason for Nomination

Pupil Nomination One

Please nominate one male pupil and one female pupil

Name

Date of Birth

Male or Female

MaleFemale

Daytime School Name

Parent/Guardian Name and Contact Address

Reason for Nomination

Pupil Nomination Two

Please nominate one male pupil and one female pupil

Name

Date of Birth

Male or Female

MaleFemale

Daytime School Name

Parent/Guardian Name and Contact Address

Reason for Nomination

Additional Information

Would you like your Complementary School to perform at the Event?

YESNO

If yes, please provide a brief description of your performance and the number of people involved;