The Duke of Edinburgh's' International Award in Australia would like to formally recognise those individuals who have provided ten years or more of service to the Award with a Long Service Medal. These are based on nominations and this can be done by the individual themselves or someone who would like to see another individual be recognised.

i.        The Long Service Medal is awarded after 10 years of service in a voluntary or paid capacity to the Award.

ii.        A medal service clasp (also referred to as a bar) is awarded for each additional 10 years’ service.

iii.      The recipient will receive a medal, a lapel pin and a certificate signed by the State/Territory Chair and the Chair of the National Award Authority.

iv.      The medal and subsequent 10 year service clasps are approved by the Division (State/Territory) Executive Officer.

v.       The issue of the medal is arranged by National Award Office.

vi.      Medals are presented at a State/Territory Award function or as arranged with the Award Unit.

vii.     The medal when worn is worn on the right chest. The lapel pin is worn on either lapel.
 
Note: Applications can be made by the recipient or a nominee

Once a nomination has been made, it is submitted to the National Award Authority for verification and if successful, will be presented to the recipient by the State / Territory Award Operating Authorities.

If successful, the nominee and nominator will be advised by email. If unsuccessful, the nominator only will be advised.

Note: Questions with an * require an answer.
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* 1. Name of Nominee (person who will receive the Medal)

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* 2. Nominees Contact Details

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* 3. Nominator/Referee 1 (Person nominating - may be the nominee however one additional referee will be required).

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* 4. Nominator/Referee 2.

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* 6. Award Active Service (please detail the role the nominee has undertaken, the Award Unit(s) or location(s) where the service was completed and the time period of that service)

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* 7. Additional Notes (Description of Nominee's service, impact on the Award, accomplishments as a volunteer etc.).

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* 8. STATEMENT OF AGREEMENT I hereby state that all the information provided on this form is true and accurate.In submitting this form I confirm that I have the authority/delegation to make this submission.

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