Nominate a Human right Defender for the Award

Nomination Form

Name of the nominee

Relationship of the applicant to the nominee

Self

First-degree relative – father, brother, sister, mother

Friend, relative, colleague

Place of residence

West Bank

Gaza

Jerusalem

1948 Palestine

Has the nominee ever been arrested by any authority (Occupation or Palestinian Authority)?

Yes

If yes: Who arrested them?

The Occupation

The Palestinian Authority

Both the Occupation and the Palestinian Authority

If yes, How many times have they been arrested?

Is the nominee currently being prosecuted for defending human rights and freedoms?

Yes

Does the nominee manage or actively participate in any social media pages?

Yes

If yes, please list the page links or handles

Does the nominee have notable initiatives or activities in defending human rights and freedoms?

Yes

If yes, please describe them

Has the nominee or any family member been threatened or pursued?

Yes

Is the nominee a member of any well-known grassroots movements for human rights and freedoms?

Yes

If yes, please specify

Has the nominee or any family member been subjected to financial, social, or employment-related harm?

Yes

If yes, please provide brief details

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