WA Mental Health Awards 2026 - Nomination Form

The Diversity & Inclusion Award recognises an individual, organisation or group that embraces diversity and promotes inclusion, through an initiative that benefits a particular population group. This group includes, but is not limited to, culturally and linguistically diverse people, youth or older Western Australians, people of different abilities, Aboriginal and Torres Strait Islanders and LGBTQIA+.

The successful nominee can demonstrate supports or activities that connect with population groups in a way that is respectful, and which reflects the interests and preferences of that group.
Submitting a nomination for the Diversity & Inclusion Award

Nominations are open to any individual or organisation. Self-nominations are accepted for this category.

Please address the following questions in a separate document and upload as an attachment to this form:
  • Please explain which population group/s this nomination relates to and what barriers the group/s face when accessing mental health services.
  • Please demonstrate how the individual or organisation helps to increase access to mental health services or supports for this group.
  • Please explain how the individual or organisation helps to foster an inclusive community in WA.
  • How has/does the individual or organisation engage with members of the specified population group/s?
The written response to the above questions should not exceed 2,500 words, excluding supporting documents or images.

For more tips on submitting a nomination, as well as a full list of nomination conditions, please view the Nomination Guide.

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* 1. Your name (person submitting the nomination)

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* 2. Your organisation or business name (if applicable)

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* 3. Your address

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* 4. Your phone number

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* 6. Nominee's name (if different to above)

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* 7. Nominee's phone number (if different to above)

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* 8. Nominee's email address (if different to above)

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* 9. What is your relationship to the nominee? Please skip this question if you are the nominee.

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* 10. Why have you chosen to nominate this person or organisation for the 2026 Diversity & Inclusion Award?

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* 11. Name of Referee 1

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* 12. Relationship of referee to nominee?

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* 13. Phone number for Referee 1

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* 15. Name of Referee 2

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* 16. Relationship of referee to nominee?

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* 17. Phone number for Referee 2

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* 19. Please upload your responses to the nomination questions above.

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