National Awards Entry Form
All entrants agree to the use of their image/information by Alzheimers New Zealand and their strategic partners for the purpose of publicity
Phone (day) Email
Category (tick as many as apply)
Outstanding Contribution in the field of Dementia Team of the Year
Unsung Hero of the Year Volunteer of the Year
Please describe your contribution (attach another sheet of paper if you need more space)
All entries must be received no later than 5pm, Thursday 1 st April 2010
All completed entry forms will be judged by a panel elected by Alzheimers New Zealand National Office.
Judges decisions are final.
Send Entries to: Alzheimers New Zealand, PO Box 3643, Wellington 6140
Level 3, Adelphi Finance House, 15 Courtenay Place, Wellington
Email: firstname.lastname@example.org or call for enquiries 04 381 2362