Online Form - Australia Day Citizenship Nominations - Australia Day 2023

Please choose one of the following: *




Award recipients must meet the following eligibility criteria:

• Recipients must be; residents of the Shire; or have coordinated a community event Within the Shire; or be members of a community group whose principal activities are conducted within the Shire; or be a business or organisation that has contributed financially or in-kind to a community project or group within the Shire
• Awards cannot be granted posthumously
• Only one person (not a couple or group) may be nominated for individual award categories
• Local Government Councillors, State and Federal politicians are not eligible to receive an Award
• Sitting members of State, Federal and Local Government are not eligible.

Do you the Nominator agree to the above criteria? *