Selection criteria:
1. Demonstrated leadership and impact
- Nominees must show clear leadership within Ballarat or surrounding communities.
Evidence of tangible impact in advancing women’s roles, opportunities, or representation locally.
- Initiatives or achievements that have contributed positively to community, business, arts, education, technology or other sectors.
2. Championing others
- Proven commitment to supporting, mentoring, or advocating for other women or underrepresented groups.
- Actions that create pathways or remove barriers for women’s growth and leadership in Ballarat.
- Contribution to building a more inclusive and diverse community.
3. Inspires others
- Ability to inspire others through their story, achievements, or character.
- Acts as a positive role model for future generations of women in Ballarat.
- Demonstrates integrity, respectfulness, and a collaborative spirit.
- Commitment to fostering equality and celebrating diversity within the local context.
4. Local connection
- Calls Ballarat (50km radius) home and demonstrates a passion for making our city a better place.

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1. Nominator Name (Required.)

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2. Nominator Organisation (Required.)

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3. Nominator Role (Required.)

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5. Nominator Phone (Required.)

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6. Nominee Name (Required.)

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7. Nominee Organisation (Required.)

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8. Nominee Role (Required.)

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10. Nominee Phone (Required.)

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11. About the Nominee (Required.)

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12.
Please describe how the nominee has demonstrated outstanding leadership within Ballarat or its communities through contributions that sit outside their paid employment, business-as-usual responsibilities, or formal role requirements. (up to 500 words).

Provide specific examples of initiatives, projects or actions they have led or influenced as a voluntary, community-minded, advocacy-based, or above-and-beyond contribution, including their role, the actions they took, who benefited and any measurable outcomes or results. (Required.)

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13.
What tangible impact has the nominee had in advancing women’s roles, opportunities, participation or representation in Ballarat through voluntary, community, committee, advocacy or other unpaid contributions, outside the normal expectations of their employment, profession, elected role or day-to-day responsibilities? (up to 500 words)

Please provide specific examples and, where possible, evidence of the scale or outcomes of their impact, such as the number of women supported, opportunities created, programs established, policies influenced or changes achieved. This nomination should focus on voluntary or community contributions, including committee roles, and not on work undertaken solely as part of the nominee’s paid employment or usual paid professional duties. (Required.)

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14.
How has the nominee actively supported, mentored, advocated for or created opportunities for other women and/or underrepresented groups through voluntary, community, voluntarily appointed to a committee, advocacy or other unpaid efforts? (up to 500 words)

Please describe the specific voluntary actions they have taken, including through any usual voluntary committee roles or community organisations responsibilities, and the difference these actions have made to individuals, organisations or the broader community. Please do not focus on activities undertaken solely as part of the nominee’s paid employment or usual paid professional duties. (Required.)

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15.
Why do you believe the nominee is a positive role model for current and future generations of women in Ballarat because of their voluntary service, committee involvement, community leadership, advocacy or other unpaid contribution? (up to 500 words)

Please provide specific examples of the values, behaviours or achievements they demonstrate, and explain how they have inspired others or created a lasting positive impact through, including any usual voluntary or community-based contribution. The focus should be on contributions beyond work undertaken solely as part of paid employment or usual paid professional duties. (Required.)

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16.
What is the nominee’s connection with Ballarat, and how has their usual voluntary service, committee involvement, community leadership, advocacy responsibilities or other unpaid contribution benefited Ballarat or its communities? (up to 500 words)

Please describe their connection to Ballarat, such as living, working, volunteering, studying, serving on committees, leading community initiatives or contributing to local organisations, and explain why their voluntary or community-based contribution is relevant to the Ballarat community. Please avoid focusing on achievements that were undertaken solely as part of the nominee’s paid employment or usual paid professional duties. (Required.)

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17. Is there anything else you would like to share about the nominee that supports their nomination? (up to 500 words) (Required.)

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18. Provide one reference (name and contact details) for the nominee (must be different than nominator). (Required.)

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