Nomination Form
Category of the nomination: *
Full legal name of Individual or Organization/Institution being nominated: *
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Contacts of Nominee
Telephone: *
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E-mail: *
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County: *
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Constituency: *
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Ward: *
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Twitter handle
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Facebook Page:
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Why does the nominee qualify for this award? Spell out what distinguishes this particular nominee from others. *
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Explain the actions taken directly and personally by the nominee and how these actions benefited the community and protected the Constitution of Kenya e.g. stopped misuse/wastage of public resources, led to arrest/conviction, resulted in community action etc. *
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Nominated by: *
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Mobile phone: *
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E-mail: *
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County: *
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Constituency: *
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Ward: *
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Twitter handle
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Facebook:
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Important additional information
Would publicity put the nominee at any risk? *
Please provide any additional information to assist in assessment of the nominee.
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