Premier's Volunteer Recognition Program - 2019

Premier's Volunteer Recognition Program - Nomination Form

The Premier's Volunteer Recognition Program recognises the contribution volunteers make towards strengthening our communities.
Both adults and students are acknowledged under the program, with each nominee receiving a certificate of recognition for their individual volunteering efforts.

Please note nominations close on 27 September 2019 at 5:00 PM.

# Please note the following:
1. This nomination form will only accept 10 nominations. For organisations wishing to nominate more than 10 volunteers, please download the form located on the Premier's Volunteer Recognition Program website .
2. When nominating a high school student, please refer to downloadable document located under Student category at Premier's Volunteer Recognition Program website.
3. All recognition certificates will be sent back to the nominator for distribution.

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* 1. Please enter your organisations details below

First name and Surname

Name of Organisation

Full Address (e.g. 2 Smith Street, Greenvalley NSW 2000)

Email Address

Phone Number

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* 2. Please enter the First name and Surname of the volunteer you are nominating to receive a recognition certificate.

First name

Surname

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* 3. Nomination Category (Please select one of the following options)

Life Long Volunteering (40+ years of service)

Long term volunteering (25+ years of service)

Project Volunteering ( for volunteering contributions at any age)

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* 4. Please describe in detail why you are nominating this Individual? (Please note a minimum of 50 words is required and no more than 100 words)

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* 5. Do you wish to make further nominations?

Yes