Australia Day Civic Awards - Nomination Form

Nominations for 2020 Australia Day Civic Awards are now open and will close on Friday 1 November 2019.

Awards will be presented during the Australia Day celebrations held at the Whitehorse Civic Centre, Sunday 26 January 2020.

How to compile your nomination: 

  • Download and read the ‘Eligibility and Conditions of Entry’ 
  • Explain the achievement/s, the background and reasons for the nomination
  • Provide any further relevant information as attachments, this may include newspaper or magazine articles about the Nominee and their achievements
  • List any awards which may be relevant
  • You must include a written submission with this nomination form - written submission should be around 500 words, maximum 2000 words. 

Submit Your Nomination

Categories
Categories
Please tick the appropriate box to indicate the category; you can nominate an individual for more than one category – providing they are eligible.
Nomination
NOMINEE
Person you are nominating for this award
Full Name
Title
Address1
NOMINATOR
Your name & details
REFEREE
Please provide the name of someone who is familiar with the achievements of the nominee who can act as a referee
Supporting Documents
You must inlcude a written submission with this nomination along with other supporting documents which you can attach below.
Written Submission should be between 500 - 2000 words.
One file only.
3 MB limit.
Allowed types: pdf doc docx.
Newspaper articles, photographs etc. You can upload more than one attachment.
Unlimited number of files can be uploaded to this field.
10 MB limit.
Allowed types: pdf jpg jpeg png.

Disclaimer

The personal information requested on this form is necessary to contact nominators and nominees and to make arrangements as necessary for the Australia Day event. This information will be used solely by Council for that /those primary purpose(s) or directly related purposes. The intended recipients of the information are Councillors and Council officers. Council may disclose the information to law enforcement agencies, courts and other organisations authorised to collect it.  Individuals have a right to seek access to their personal information and make corrections by phoning 9262 6333 and asking for the Governance Unit. You may view Council’s Privacy Policy on our website www.whitehorse.vic.gov.au or obtain a copy from any of the Council offices.

Eligibility and Conditions of Entry