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Young Achiever Awards
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Nomination Form
Young Achiever Awards
Entry Criteria
Nomination Tips
Conditions of Entry
Download PDF Nomination Form
Media Centre
 
  NT
  QLD
  SA
  TAS

You are required to provide supporting information with this submission.
Any photographs or attachments need to be emailed to:   NT   - info@awardsaustralia.com
  QLD   - info@awardsaustralia.com
Please see Entry Criteria and Conditions of Entry.

Nominees Name
Address
Postcode
Contact Telephone No.
Telephone (After Hours)
Mobile
Email
Date of Birth
Under 27 years old (see conditions)
State being nominated for:
Current Residence (State)
How many years have you lived in your current state?
Local Council Area
Local Newspaper
Categories Nominated: Career Achievement / Trade & Career Achievement
  Arts
  Regional Initiative / Regional & Rural Initiative
  Community Service
  Science & Technology / Science & Engineering
  Environment
  Sports
   
(award NT only)
 Young Carer's Award
(award NT only)
 Youth Leadership Award
If nominated by someone:
Name of Nominator
Title / Position
Company
Address
Postcode
Contact Telephone No.
Telephone (After Hours)
Mobile
Email
Summary of the nominee (up to 2000 words)
It is important that you try to keep to the guidelines in the criteria.
Is the Nominee aware of nomination? Yes No
Please advise the following of Judging results. Nominator Nominee
Has the Nominee been nominated previously? Yes No
How did you hear about the Awards?
TV Radio Paper
  Other (specify)
REFEREES – Please indicate two people who are conversant with the nominee or community group's achievements and who would act as referees for this nomination.
1. Name
Title / Position
Company
Address
Postcode
Contact Telephone No.
Telephone (After Hours)
Fax
Mobile
2. Name
Title / Position
Company
Address
Postcode
Contact Telephone No.
Telephone (After Hours)
Fax
Mobile
I have read and accept the conditions of entry. Yes
     

 

Download PDF Nomination Form
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