United Nations Environment Programme (UNEP) Green Star Awards

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Nomination Form

The Green Star Awards Nomination Form 2009

Governments, organizations, corporations and individuals may nominate themselves. All nominations must be supported by a letter from three referees who are familiar with the nominee’s work.

Fields with a * are mandatory.

Name of nominee* (individual or organisation)
Category	Aid donor government Aid recipient government Organization Corporation Individual
Nationality*
Address
Telephone
Fax
E-mail*
Date of Birth (if individual)
Date of Establishment (if organisation)
Tick one:	Male Female Organisation

Summary of achievements*
Please summarize in 300 words why this nominee should be considered for the Green Star Awards.

Press clippings, testimonials and photographs should be attached to support the nomination. Please do not send books, videos etc. Short listed applicants will be contacted for further supporting information. Nominations for the Green Star are accepted online at http://www.unep.org/greenstar, via email to greenstar@unep.org, or by mail to: Green Star Awards Joint UNEP/OCHA Environment Unit United Nations Palais des Nations- bureau D-117 CH-1211 Geneva 10 Switzerland Deadline for submissions: 30 January 2009

Nominator
Name*
Address
Telephone
Fax
Email*
Profession
Date

Referee 1.
Name (First,Last)*
Address:
Telephone:
Fax:
E-mail*:
Profession:
Date:

Referee 2.
Name (First,Last)
Address:
Telephone:
Fax:
E-mail:
Profession:
Date:

Referee 3.
Name (First,Last)
Address:
Telephone:
Fax:
E-mail:
Profession:
Date: