Young Person of the Month Award

Whitehorse City Council’s Young Person of the Month Award celebrates the achievements of young people who have excelled in the areas of learning, arts and culture, sport or community participation.

Award winners receive a JB Hi-Fi gift voucher, feature in an article in Council’s publication, Whitehorse News and may appear on Council's social media channels.

The Whitehorse Young Citizen of the Year winner is chosen from the previous year’s monthly winners and is announced at Council’s annual Australia Day celebrations.

The nomination form makes sure a wide-range of young people can be nominated. Some sections may not be relevant to the young person you are nominating. However, please complete as many of the relevant questions as possible. Read the criteria for nomination before preparing your submission. It is compulsory that the nominee also complete their authority form ( PDF 522.32KB).

Complete the online form below or you can download and complete a copy of the form ( PDF 516.91KB).

Nominee

Person you are nominating for the Award

Name

Address

Contact Number

Email Address

Date of Birth

Nominator

Your details

Name

Title/Position

Email Address

Address

Contact Number

Referee

Person who is familiar with the achievements of the nominee, who can act as a referee.

Name

Title/Position

Email Address

Address

Contact Number

Further Details

Who should be contacted, in the first instance, regarding the outcome of this nomination?

Full Name

Address

Contact Number

Is the nominee a resident in the City of Whitehorse?

Does the nominee work or study within the City of Whitehorse?

Which school does the nominee attend?

Is the nominee an Australian Citizen?

Community Group Participation

Is the nominee a member of or do they participate in any of the following groups:

1. Community

Source	Community
Name of Group	Name of Group
Number of years as a member	Number of years as a member
Their role in the group	Their role in the group

List of achievements of the nominee (not the group)

2. Sport/Recreation

Source	Sport/Recreation
Name of Group	Name of Group
Number of years as a member	Number of years as a member
Their role in the group	Their role in the group

List of achievements of the nominee (not the group)

3. Music/Drama

Source	Music/Drama
Name of Group	Name of Group
Number of years as a member	Number of years as a member
Their role in the group	Their role in the group

List of achievements of the nominee (not the group)

4. Academic

Source	Academic
Name of Group	Name of Group
Number of years as a member	Number of years as a member
Their role in the group	Their role in the group

List of achievements of the nominee (not the group)

Other Information

Please provide a ‘snapshot’ of a typical week for the young person, including study and extra-curricular activities.

How does the young person present a positive image of young people in the City of Whitehorse?

Is there anything else that you would like the review committee to know that has not been covered in the previous sections?

Additional information for consideration

Or upload supporting statement

(if more than 100 words)

One file only.
5 MB limit.
Allowed types: pdf, doc, docx.

Authority to be Completed by the Nominee

Please ask the nominee to complete this Nominee Authority Form ( PDF 522.32KB), giving their permission for Council to use the information contained in the Young Person of the Month Nomination. Attach the completed form, along with a their digital photograph – an image of them participating in an activity they enjoy is preferable. Please do not include others in the image.

Upload Nominee Authority Form and their photograph

Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Select the checkbox to confirm this is a valid submission.

Make sure to attach the completed Nominee Authority Form along with your nomination

Download Nominee Authority Form

Criteria for Nomination

For more information contact Council’s Youth Services Team Leader
Email: frank.perone@whitehorse.vic.gov.au
Phone: 9262 6383

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