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Propose a Plaque
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Name of Nominator
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Your answer
Email address
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Your answer
Phone number
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Your answer
Community group
Your answer
Name of nominee
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Your answer
Date of birth of nominee
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MM
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DD
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YYYY
Date of death of nominee
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MM
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DD
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YYYY
Please complete, based on the guidelines:
Please give a summary of the life and work of your nominee (c. 100-150 words)
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Your answer
Please explain how your nominee improved the lives of women or provided a role model for women.
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Your answer
Has your nominee been memorialised or celebrated previously? If so, when, where and how?
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Your answer
Each Plaque costs between £500 and £1,000. Would you need assistance to help raise this money?
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Has a building or site been identified for the installation of a plaque? Could you help with the practicalities locally? Please provide the post code of suggested possible buildings.
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Your answer
Please provide the name of a referee, and their contact details. This should be someone who can provide additional support to the proposer/s.
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