MALAWI ORDER OF NATIONAL ACHIEV

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					      MALAWI ORDER OF NATIONAL ACHIEVEMENT
                 Nomination Form


Nominee’s Details (The Person you are nominating for an award)

Full Name:……………………………………………………………………

Company/Organization Name:………………………………………..........

………………………………………………………………………………...

Address……………………………………………………………………….

………………………………………………………………………………..

Title/Position:………………………………………………………………..

Nationality:………………………………………………………………….

Telephone Nos:………………………………................................................

E-mail Address:…………………………………………………………….


Nominator (The Person who is submitting the nomination)

Name:…………………………………………………………………………

Company/Organization Name:……………………………………………..

Title/Position:………………………………………………………………..

Address:…………………………………………………………………….

………………………………………………………………………………..

Village:……………………………….Traditional Authority:…………......
District:………………………………Telephone Nos:…………………......

E-mail Address:……………………... …………….………………………..

Date:………………………………….Signature:....………………………..


Seconder’s Details (The Person who supports the nomination)

Name:………………………………Title/Position:………………………...

Address:………………………………………………………………………

………………………………………………………………………………..

Telephone Nos:………………………………………………………………

Date:………………………………….Signature:....………………………..


Details of Referees
(Please provide details of two people who are able to make direct comment on the
contribution/service of the person you are nominating)

Referee I

Name:………………………………Title/Position:………………………...

Address:………………………………………………………………………

………………………………………………………………………………..

Telephone Nos:………………………………………………………………

E-mail Address:……………………………………………………………..

Referee II

Name…………………………………Title/Position:……………………….

Address:………………………………………………………………………
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………………………………………………………………………………..

Telephone Nos:………………………………………………………………

E-mail Address………………………………………………………………

Nomination Statement
In a separate sheet of paper, please explain and provide evidence on:-

   a) the areas the nominee has excelled;
   b) how the nominee has demonstrated outstanding service worthy of
      recognition;
   c) how the nominee’s contribution has impacted a particular field, lives
      of individuals, locality, group, community or humanity at large;
   d) over what period of time has the nominee made major contribution to
      society or humanity in general; and
   e) whether the nominee’s contribution has been recognized elsewhere
      (locally and abroad), whether the nominee’s ideas, theories,
      innovations, and inventions can be or have been replicated elsewhere
      for the benefit and well being of the Malawi nation and humanity in
      general.

Additional Information
You are allowed to include any additional information you feel is important
for your nominee to be considered for the awards.

Submitting the Nomination Form
Please send your nomination form together with your nomination statement
by post, courier, e-mail or hand to the following address below:-

      The Secretariat
      Civilian Honours and Decoration Committee
      Office of the President and Cabinet
      P/Bag 301
      Lilongwe 3.
      e-mail: cabinet.office@opc.gov.mw
      Attention: Clerk to the Cabinet

Or you can submit your nomination form and nomination statement through
the District Commissioners’ Offices and Chief Executives of City,
Municipal and Town Councils.

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