APSAD Advocacy Award Nomination Form

APSAD Advocacy Award Nomination Form

The Advocacy Award recognises the outstanding impact by an individual or a team in the alcohol, tobacco, and other drugs sector who works in the policy and /or advocacy area.
Eligibility

Any individual or team who has made an outstanding impact in policy and/or advocacy in the alcohol, tobacco, and other drugs field, and can demonstrate one or more of the achievements below:
- positive advancement in the understanding of alcohol, tobacco, and other drugs issues in a given community or population group, or
- advocacy for an advancement that is in the public interest (public health or welfare and/or criminal justice), evidence based (evidence that it will work as intended), and has a focus on reducing drug related harm, or
- positive policy change for the alcohol, tobacco, and other drugs field. Change could occur in the following areas but are not limited to; legislative, government, and community, or
- strategy formation, e.g., strategic thinking, coalition formation, government liaison, key messaging.
Selection Criteria

Applicants must provide evidence of the impact made in the alcohol, tobacco, and other drugs field. The nomination should clearly describe the achievements to be honoured, the scope and depth of the impact, and the processes used by the nominee, including for instance, strategy information and the use of evidence to underpin the advocacy /policy.

NOMINATOR'S DETAILS

Details and contact information for the person who is nominating
Name*

PrefixFirst NameLast NameSuffix
Organisation*
Include the organisation of the nominator
Current Position*
What position does the nominator hold
Email*
Nominator's email address
Phone Number*

Country CodeArea Code (0 for mobile)Phone Number
Confirmation the Nominator is a current APSAD member*

Yes, I confirm my membership is current
NOMINEE'S DETAILS

Details and contact information for the person being nominated for this Award
Name*

PrefixFirst NameLast NameSuffix
Organisation*
Include the organisation of the nominee
Current Position*
What position does the nominee hold
Email*
Nominee's email address
Mobile Number*
Nominee's mobile number
Qualifications

Include qualifications for the person being nominated, including year obtained and where.
Qualification Qualification* . Year Year qualification was obtained* Where Institution qualification was obtained .
Qualification Qualification . Year Year qualification was obtained Where Institution qualification was obtained .
Qualification Qualification . Year Year qualification was obtained Where Institution qualification was obtained .
Qualification Qualification . Year Year qualification was obtained Where Institution qualification was obtained .

SELECTION CRITERIA

Applicants must provide evidence of a special, unique, or substantial contribution to alcohol and other drug research as demonstrated by, for example, the range and quality of their evidence-based research outputs; broader dissemination and/or implementation strategies to scientific as well as broader audiences (i.e., general public, clinicians, policy makers, other stakeholders); development of an independent research program that may be supported by a peer reviewed grant.
Upload the nominator's supporting statement and the nominee's contribution summary below, make sure you stick to the allocated word limits.
NOMINATOR*

Indicate the Nominee's (an individual or team) outstanding impact in policy and/or advocacy in the alcohol, tobacco, and other drugs field - max 500 words.
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NOMINEE'S CONTRIBUTION SUMMARY*

Provide a brief summary - no more than 2,000 words - outlining your contribution as per the selection criteria to the alcohol, tobacco and other drugs field.
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SUPPORTING DOCUMENTATION

Upload your supporting documentation. Nominee’s CV (if an individual); show the positive impact of the policy and/or advocacy in the alcohol, tobacco and other drugs field. Provide a description of the process used including strategy formation, evidence of the scope and depth of the impact, and the use of evidence to underpin the advocacy or policy efforts.
Supporting Documentation Upload*

Upload your supporting documentation
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Use the checks boxes below to ensure you have completed the form and uploaded all required information before submitting the form*

A brief statement indicating why you support the nomineeNominee's contribution summaryUploaded the nominee's CVSupporting documentation has been uploaded

DECLARATION

Both Nominator and Nominee are required to confirm the information provided in this form is accurate and true.
Nominator's Declaration:

To confirm your support for this nomination, you can;
- sign this form, or
- send an email confirming your nomination to awards@apsad.org.au
Nominator: As an APSAD member I submit this nomination for the APSAD Advocacy Award.

Clear
Confirmation from the nominator
NOMINEE'S CONFIRMATION*

I agree to be nominated for consideration for the APSAD Advocacy Award and confirm should I be successful will be attending the APSAD 2025 in Gadigal (Sydney) to receive the Award.If I am the successful recipient of the Advocacy Award, I understand I have the opportunity to present an Advocacy or Policy workshop at the 2026 APSAD Conference in Perth
Nominee's Signature

Clear
confirmation from the nominee
Should be Empty:

Eligibility