Colleague nomination form

Please complete all fields marked with * before submitting this form.

Nomination details

I am nominating:*
(Name of colleague)

Who works at:*
(Depot/Office)

Position held:

First area:*
(please select)

I think this person is a Superstar because (please give your reason for this nomination)

Your comments:*

Date:*

Your title:

Forename:*

Surname:*

Address 1:*

Address 2:

Address 3:

Post code:*

Daytime phone no.:*

Email Address:
(if applicable)

If your nomination gets judged the Superstar of the month you could win a High Street voucher worth £25.

Thank you for your help.