Proposer’s Details

Name

Team Name (if applicable)

Membership type

Address

Postcode

Telephone

Email Address

Seconder’s Details

Name

Team Name (if applicable)

Membership Type

Address

Postcode

Telephone

Email Address

Nominee’s Details

Name

Team Name (if applicable)

Membership Type

Nomination Type

Address

Postcode

Telephone

Email Address

Nominations may be made by any HRGB member and duly seconded but must be made without the knowledge of the nominee to avoid embarrassment.

Please give your reasons why the nomination should be considered in no more than 200 words.

Please check the contents of the form