Nominee Individual Responses 2025

1.

Name

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2.

Nominated by: (if known)

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3.

Please provide us with details of the Group/Club(s) you work with (if applicable) and the roles you have with each.

4.

How long (in years) have you been involved with each Group/Club (if applicable)?

5.

Have you been recognised in any other ways? This could include other awards, state/national titles, major achievements etc.

6.

Outline your contributions to the community. This may include volunteer work, leadership roles, projects initiated, or any other activities that have positively impacted the community.

Share specific examples of the impact your contributions have had on individuals or the community as a whole. Feel free to include testimonials or success stories if available.

7.

How do you hope to continue providing positive outcomes in the community into the future? This could include upcoming projects, initiatives, or goals.

8.

Please share any additional information you would like to share with us.

9.

Can you please upload a photo(s) of yourself for our marketing team? If possible a photo of you undertaking the role you have been nominated for would be best.

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10.

If you have any documents you want to share with us, you can upload them here.

11.

First reference details:

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12.

Second reference details: