Nomination Form - 2020 Australia Day Awards Incorporating the Shoalhaven Medal

Please note: this nomination form must be completed in one session as you cannot return to the form to add extra information once submitted. It is suggested that you type your answers in a word document and cut and paste into the online form as your responses will only be saved at the end when you submit the form. 

Alternatively, you can download a hardcopy Nomination Form, print, complete and return to Council.

Nominations must be received by 5.00 pm on Friday 22 November 2019.

You may provide any information (maximum 10 pages) or other documentation that may support this nomination.

Eligibility

  • Only individuals may be nominated. The nomination of a club or association or any other organisation will not be accepted.
  • Nominees are those that have made significant contributions to the city.
  • Persons who have previously been nominated but have not been awarded a Shoalhaven Medal or Australia Day Award in that category are eligible to be nominated again.
  • Individuals cannot nominate themselves.
  • Individuals, associations or clubs may nominate a Candidate.

Assessment

Nominees will be assessed on the basis of information provided in this nomination form and attachments. Nominators are asked to take care in completing this form and are encouraged to provide complete and accurate information about the nominee.

Entries will be considered by the Judging Panel whose decision will be final and no correspondence will be entered into. The judging panel will be looking not only at the length or value of service but also the quality of the service, including individual acts of compassion, generosity, bravery, ingenuity, creativity or professional accomplishments. Should a nomination be received which is better suited to a different category, the Panel reserves the right to reassign the nomination to the more suitable category.

Information to Include

Please list specific details and examples. Generalised statements such as “the Nominee is community minded” or “the Nominee is willing to offer assistance whenever needed” may be true; however, they do not provide enough relevant information.

Details of Nominee

Please provide the details of the person you are nominating for an Award.

Maximum characters 255
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Nomination Information

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Details of Nominator

Please provide your details or the details of the association or club nominating the candidate.

Maximum characters 255
Maximum characters 255
Maximum characters 255
Maximum characters 255

Declaration of Nominator

Options are limited to
Options are limited to
Maximum characters 255
Maximum characters 255
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