Tammin Achievement Awards

Shire of Tammin
Tammin Achievement Awards
Achievement Awards Ceremony 2019

Nomination Form
AWARD CATEGORY

(Please tick one appropriate box only – a separate nomination form needs to be completed for each category if nominating a person/group for multiple awards)
Type a question*

2018 Citizen of the Year2018 Senior Citizen of the Year (Over 65Years)2018 Youth Citizen of the Year (25years and Under)2018 Recognition Award (Open)
Completed nomination forms must be submitted by: Close of Business on Monday, 11th February 2019

Council will consider all nominations at the February Council Meeting.

The Awards will be presented on Thursday 14th March 2019 at the Tammin Bowling Club. All finalists will be notified by the Shire directly.

SHIRE OF TAMMIN ACHIEVEMENT AWARDS GUIDELINES & CRITERIA

The Tammin Achievement Awards are to acknowledge Tammin residents for their contribution in making a difference to our community, and recognise those who have achieved success in sporting, cultural, community events and who put in that extra effort not only in their contribution, but those that become role models and encourage and motivate others to step out and set new boundaries of achievement.

GUIDELINES

The recipient will be chosen based on the following guidelines:
- Significant contribution to the local community
- Demonstrated leadership on a community issue resulting in the enhancement of community life
- A significant initiative which has brought about positive change and added value to community life
- Inspiring qualities as a role model for the community
CRITERIA
- Citizen of the Year: A person you believe has delivered outstanding service to the community during the past year.
- Senior Citizen of the Year: A senior person you believe has delivered outstanding service to the community during the past year. To be eligible, the person must be over 65 years of age on March 14th, 2018.
- Youth Citizen of the Year: A young person you believe has delivered outstanding service to the community during the past year. To be eligible, the person must be under 25 years of age on March 14th, 2018.
- Recognition Award: Applies to a community member who has had a significant or outstanding achievement this year in any given field of endeavour.

Name(s) of Person/Group*
Address*

Street Address

Street Address Line 2

CityState

Postcode
Phone Number*

Area CodePhone Number
Please provide as much detail as possible about the person/group that you are nominating – remembering the criteria to the category that you have chosen.*
Any other relevant background details (Additional material may be attached if desired):*

Other persons who may be contacted for further information about nominee:
Name*

First NameLast Name
Position *
Address*

Street Address

Street Address Line 2

CityState

Postcode
Phone Number*

Area CodePhone Number
Email*
example@example.com

Nominator's details: (The person Submitting nomination)*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Organisation represted (if any)
Signed*
Date*

DayMonthYear
Date
All portions of the form must be completed. Incomplete forms will not be accepted.

It is the responsibility of the nominator to seek as much information on the nominee as possible.
Should be Empty:

Shire of Tammin

Tammin Achievement Awards

Achievement Awards Ceremony 2019