10 — Sunday Territorian, Sunday, June 20, 2010 www.sundayterritorian.com.au
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Pride of Australia Northern Territory News Nomination Form

Published on: Mar 4, 2016

Transcripts - Pride of Australia Northern Territory News Nomination Form

  • 1. 10 — Sunday Territorian, Sunday, June 20, 2010 www.sundayterritorian.com.au PUB:NTNEWSDATE:20-JUN-2010PAGE:10COLOR:CMYK www.prideofaustralia.com.au Title: Mr Mrs Ms :emantsriF:emanruSrehtO Date of birth: (If not known, approximate age) Is the nominee an Australian citizen? Yes No Not sure Nominee’s country of birth (if known): Street Address (or Postal Address): State:Town/City: Postcode: )W((if known) (H):enohP Mobile: nominationform nominee’sdetails (Details of the person or group you are nominating. Please provide as much information as possible.) Please tick this box if you are nominating two or more people in the Outstanding Bravery, Heroism, Community Spirit, Care and Compassion or Environment categories. (Please attach additional nominees on a separate piece of paper) Tell us in at least 100 words about your nominee and why they deserve a prideofaustralia™medal. How have they inspired you or contributed to your life or the lives of others in the community? (Please write or type on a separate A4 sheet of paper and attach it firmly to this form). How did you find out about the prideofaustralia™medal? Title: Mr Mrs Ms :emantsriF:emanruSrehtO Street Address (or postal Address): State:Town/City: Postcode: )W((H):enohP Mobile: nominator’sdetails (Your details) Signed: Date: (nominator) prideofaustralia™ medalcategories Please tick this box if you do not wish to be identified as the nominator to the nominee. Please tick this box if you do not wish to be contacted in future years in relation to the prideofaustralia™ medal. Please tick this box to confirm you have read Rules of Entry. The prideofaustralia™medal honours Australians who do extraordinary things – the unsung heroes of our communities whose contribution to Australian life is not widely known. These people are not high-profile Australians. They might be a friend, workmate, neighbour, your child’s teacher, the local police officer or firefighter or simply someone who has made your community a better place to live – you can even nominate yourself. If you know someone who has contributed to the community and reflects the core value of giving and not receiving, then fill out the nomination form below with as much detail as possible. (Note: Supporting information supplied will not be returned) Email: Outstanding Bravery Medal: For an Australian, or group of Australians, who, through their act/s of bravery, helped save or attempted to save a life/lives. Courage Medal: For an Australian, whose act/s of courage have overcome personal adversity through determination and strength of character. Heroism Medal: To recognise a member or members (professional or volunteer) of the police, fire, ambulance, coastguard, air rescue service who work, or have worked, on the frontline to protect the community. Community Spirit Medal: To recognise an individual or a group whose selfless and largely unacknowledged actions have enriched the lives of those around them in their community. Child of Courage Medal: A child 16 years or under who has helped save, or attempted to save, the life of another or overcome personal adversity through strength of character. Young Leader Medal: A person under 25 years who has advanced a community, or will advance a community, through academic or personal endeavours. Care and Compassion Medal: To recognise a professional or volunteer carer or group, nurse or member of the medical profession who has made a significant improvement to the lives of those around them. Inspiration Medal: To recognise a member of our teaching profession in primary or secondary school, State or Independent, who has been truly inspiring. Environment Medal: For an Australian or group of Australians whose actions prove that by making one degree of difference to their local environment, people can make a difference to the broader community. Fair Go Medal: For an Australian permanent resident or citizen, born overseas, who has enriched Australia through their honesty, hard work and willingness to embrace their new home. Serving Australia Medal: For an Australian in the defence force, on or off the frontline, who showed extraordinary courage and devotion to duty under extreme circumstances or a former member of the defence force who continues to serve their community and country. NOMINATIONS CLOSE 5pm, TUESDAY, JULY 6, 2010. Send the completed form and additional documentation to: NT News prideofaustraliaTM medal 2010, GPO Box 1300, Darwin, NT 0801. Or you can nominate someone online at www.prideofaustralia.com.au Should you require help with your nomination please call (08) 8944 9900 between 9am and 5pm Monday to Friday. You will need to read the Rules of Entry carefully which are available online at www.ntnews.com.au/pride or at NT News reception, McMinn Street, Darwin. Please tick the appropriate category box for your nominee. You may only select one category: prideof australia medal2010 ™ nominate an unsung hero today PRIDE O F A U S T RALIA PRIDE O F A U S T RALIA 2 0 1 02 0 1 0 *Kate Smith: Winner of 2009 Victorian and national prideofaustralia™ Young Leader medals. mg480702

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