Nomination form for Black History Month installation

Use this form to nominate a resident or organisation supporting and empowering H&F's Black community. We're looking for those who embody the theme Standing Firm in Power and Pride.

The two successful nominees will have their image and story displayed on lampposts along King Street throughout October.

You must be aged 18 or over to nominate someone.

We ask for your phone number and email address so we can contact you if your nomination is successful.

We ask for the first part of your postcode to help us analyse the reach of our campaign.

Before completing the nomination form please read our terms and conditions (opens in new window).

All fields are required unless marked (optional).

Your details

For example, W12.
Are you aged 18 or over?
Do you live, work or study in the borough?
Please tick all that apply.

Your nomination

If picking a group, charity or business please identify the person or couple within that organisation you would like to nominate.

Who are you nominating?
This year's Black History Month theme is Standing Firm in Power and Pride. Please keep your citation concise - 500 words maximum.
Please keep your description concise - 250 words maximum. 
This image is for reference. If your nomination is successful, we will arrange for a photographer to take photos for the art installation.
One file only.
10 MB limit.
Allowed types: jpg, jpeg, png, gif, bmp.

Your consent and agreement

Please confirm your acceptance of the following.

Photographer's photo consent
Terms and conditions agreement

Marketing

May we contact you for marketing purposes?

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