Category: Community Resource Social Inclusion Community Resilience Unsung Hero

Continue on separate sheet/s if required 

Municipal District: Ballinamore Carrick on Shannon Manorhamilton

Name of Group :  Contact:(Name, Phone, Email)

Address: 

Phone: Email:

Which of the following describe your entry? Tick all that apply and add brief detail

Voluntary Effort / involvement ________________________

Supporting participation in local life ________________________

What are the benefits of your facility? ________________________

Example of community resilience ________________________

How this person helped the community ________________________  

Does your group meet the needs of any of the following target groups: Older People Unemployed Disabled People Minority Groups Traveller Community People living in isolated areas Women, Youth & children Disadvantaged communities Why does your group/unsung hero deserve this award?

Why does your group/unsung hero deserve this award? (Continued)

PPN registration number : ____________________________________________ If your group is not registered with Leitrim PPN contact us for an application form on 08701831253 orjoin online at https://www.leitrimppn.ie/join-ppn/

Please include 2 or 3 photographs that represent your group’s activities best. These will be used on the Awards night in October. Please tick to consent to photos provided being usedMax email size 10MB total. Judging will take place in July or August 2019.The Judge’s decision is final and no correspondence regarding results will be entered into. 

Send Applications to:Leitrim PPN, Áras an Chontae, Carrick on Shannon

or by email to info@leitrimppn.ie by Wednesday 10th April 2019 

Continue on separate sheet/s if required