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Australia Day Nominations

Australia Day Nominations

Do you know someone who deserves recognition?

The Swan Hill Rural City Australia Day Local Government  Awards provide an opportunity to acknowledge and celebrate the contributions made by members of our community.

Anyone can nominate someone they believe deserves recognition for their valuable and selfless efforts.

There are three award categories:

Australia Day Citizen Award To be eligible, the person must be 30 years or older on January 26 2018.
Australia Day Young Citizen Award To be eligible, the person must be under 30 years on January 26 2018.
Community Event of the Year Award Presented to the person/group who has staged the most outstanding community event during the year.

Nominations close at 5pm Thursday 23, November 2017.

Nomination Form

Award Category

Award category:

Details of the person being nominated

Name:

Address:
Phone (A/H):
Phone (B/H):
Mobile:
Age or DOB:
Marital Status:
Children:
Contribution/s to the community for which the person is being nominated

Other significant contribution/s and achievements

Past and present membership of community / sporting / professional bodies etc.

Any other relevant background details

Your details

(person submitting nomination)

Name:
Address:
Email:
Organisation (if any):
Phone (A/H):
Phone (B/H):
Mobile:

Referee

(details of another person who can support this nomination)

Name:
Address:
Phone (A/H):
Phone (B/H):
Mobile:
 

Community event of the year (if applicable)

Name of person or group:
Title of the event:
Event Details:

Supporting Material

(Upload: pdf, doc, docx, jpg, png. Limit: 3MB per file)