Delegate Achievement Award nomination form

Fill in the below form to nominate a delegate.

You may send any supporting documentation to trish.mckinnon@psa.org.nz

Delegate nominated

Which delegate award are you making a nomination for?

Name of nominated PSA delegate:

Workplace:

Location:

Sector:

Share examples of outstanding leadership above and beyond expected duties of a delegate (specific & detailed information is required)

Supporting documents can be emailed to trish.mckinnon@psa.org.nz

Has this nomination been endorsed by onsite delegate committee? (if applicable)

PSA organiser's name

Nominee's direct manager's name

Nominated by, or on behalf of

Name:

Email address:

Telephone number

Name of person seconding this nomination

Date of nomination

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Delegate Achievement Award nomination form

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Delegate Achievement Award nomination form

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