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Nomination Form for SHA Merit award

S W E L L E N D A M   H E R I T A G E   A S S O C I A T I O N

S W E L L E N D A M   E R F E N I S V E R E N I G I N G

NOMINATION FOR SWELLENDAM HERITAGE ASSOCIATION MERIT AWARD

NOMINASIE VIR SWELLENDAM ERFENISVERENIGING MERIETE TOEKENNING

PLACE NOMINATED / PLEK GENOMINEER:

Please provide the name and address, or a description and location. (It may be any building, structure, space, environmental feature, etc. in the Swellendam Municipal Area.)

Verskaf asseblief die naam en adres, of ‘n beskrywing en die ligging. (Dit mag enige gebou, struktuur, oop ruimte, omgewingseienskap, ens. wees in die Swellendam Munisipale Gebied.)

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If possible, please name the person/persons to whom the award should be presented, with contact details (e.g. telephone no.) if known:

Indien moontlik, noem die mens/mense aan wie die toekenning gemaak moet word, met kontaksdetails (b.v. telefoonnommer) indien bekend.

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MOTIVATION / MOTIVERING

(Contribution to the beauty, amenity or heritage of greater Swellendam.  

Bydrae tot die skoonheid, beleefdheid of erfenis van die Groter Swellendam Gebied. )

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Nominated by / Voorgestel deur:

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