Australia Day Awards - Nomination Form

Nominations for the 2019 Australia Day Awards are now open.

For more information, contact Council on 03 5832 9700.

Nominations close on 30 November 2018.

Please note: nominations for Murchison close on 23 November 2018, due to an external judging process.

* Fields marked with an asterisk are required.

You can select more than one.

Nominee (the person you would like to nominate)

Tell us about your nominee

Nominator (your details)

Referee

(other person who can be contacted for further information if required)