On behalf of [name of Federation member society] (required)

as the result of decision made at a committee meeting held on (required):

I hereby nominate [full name] (required):

as a person worthy to receive recognition for work done to promote the hobby of philately and/or deltiology.

The following is a summary of the nominee's contribution to the hobby of philately and/or deltiology.

I certify that the facts as given above are, to my personal knowledge, a true record of the contributions of the nominee.

Full name of nominator (required)

Position in member society (President or Secretary only). (required)

Email address of nominator (required)

Please complete the following simple question: