Clone of Award Nomination Form

The nomination requires: 

300-word maximum statement in support of the individual, group or organisation that is being nominated 

Name and contact details of a supporting referee 

Name and contact details of the person making the nomination 

For questions, additional information, or support with your submission, please contact us at heyyoumob@fneha.com.au
CONTACT PERSON FOR AWARD NOMINATION

CONTACT PERSON FOR AWARD NOMINATION
Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Position / Job Title *
Name of Organisation*
Heading

NOMINATION DETAILS
Name of Individual/ Group/ Organisation nominated *
Phone number of key contact for Individual/ Group/ Organisation nominated *
Please nominate no more than two presenters for Table Top presentations
Email of key contact for Individual/ Group/ Organisation nominated*
Please indicate the authors and/or presenters who identify as Aboriginal and/or Torres Strait Islander
If Individual: is the person nominated of Aboriginal or Torres Strait Islander origin?*
If group/ organisation: Is the group/ organisation nominated Aboriginal or Torres Strait Islander controlled?*
Award category for nomination*
Heading

REFEREE
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Name of Organisation *
STATEMENT OF SUPPORT

(max 300 words)
Cancelof
Should be Empty:

CONTACT PERSON FOR AWARD NOMINATION