CHRC Australia Day Awards Nomination Form 2025

First we need to know about you!

Your information will not be disclosed to the nominated person.
Your Name*

First NameLast Name
Your E-Mail Address*
example@example.com
Your Phone Number*
Please enter a valid phone number.
Next, we'll ask you about your chosen nominee

Who are you nominating for an award?

We will need as much contact information as possible so that we can ensure they come to an award ceremony.
Nominee's Name*

First NameLast Name
Nominee's position or title
E.g. 'CEO' or 'retired' or 'accountant'
Nominee's business or organisation
E.g. 'Central Highlands Regional Council'
Nominee's year of birth*
This is especially important if you are nominating a child, so that we can ensure they are placed in the correct category.
Nominee's E-Mail Address
example@example.com
Nominee's Phone Number*
Please enter a valid phone number.
Nominee's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Now we can get to the fun stuff...

Why are you nominating this person for an award?
Please provide as much information as you can and address the selection criteria which can be found on our website. Make sure to mention:
- In what role(s) or area(s) has the nominee excelled
- Specific examples of how they have gone above and beyond
- A list of their personal, academic and professional achievements or recognitions
- A list of any positions, appointments or memberships they have held
- Their personal attributes
- How the person/event/organisation has:
  - made an outstanding contribution to the community (social, cultural, economic, etc.)
  - inspired the community
- Why the person’s/event’s/organisation’s contributions should be recognised with an Australia Day Award?
Please type your answer below:*
Do you have any supporting documents or photos of this person?

Please upload any supporting documents or photos of the nominated person here.
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Why are you nominating this event for the Community Event of the Year award?
Please provide as much information as you can and address the selection criteria which can be found on our website. Make sure to mention:
- How has this event contributed to the development of the regional economy?
- How has this event contributed to social and cultural life in the Central Highlands?
- Provide data to substantiate such as participant numbers, organisations involved, and revenue generated.
Please type your answer below:
Do you have any supporting documents or photos of the event?

Please upload any supporting documents or photos of the event here.
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CHRC Australia Day Awards Nomination Form 2026