Australia Day Awards 2023 Nomination Form Question Title * 1. Detail of person or organisation being nominated: Name Address City/Town State/Province ZIP/Postal Code Country Phone Number Question Title * 2. Age of person being nominated (age required for Junior Awards) Question Title * 3. OPTIONAL: While its not essential, if you have a photo of your nominee then we'd be happy to include the picture as part of your nomination Please follow the 'choose file' option to upload your photo. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please follow the 'choose file' option to upload your photo. Question Title * 4. Is the nominee an Australian Citizen? Yes No Question Title * 5. Is the nominee aware they have been nominated? Yes No Question Title * 6. Would they accept the award if selected? Yes No Question Title * 7. You are nominating this person for the following award: Citizen of the Year (Over 26 years of age) Young Citizen of the Year (Under 26 years of age) Cultural Award Senior Sports Award (Over 17 years of age) Junior Sports Award (Under 17 years of age) Sports Administrator Award (Over 17 years of age) Volunteer of the Year Award Community Group Award Community Event Award Question Title * 8. Your nominating this person from the following area: St George Dirranbandi Bollon Mungindi Nindigully Thallon Question Title * 9. Please tell us about your nominee in 400 words or less: Question Title * 10. Please list up to 5 achievements of your nominee: Question Title * 11. In 25 words or less, tell us why your nominee deserves an Australia Day Award: Question Title * 12. Nominator Details: Name Address City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 13. Name of organisation nominator is representing (if applicable) Done