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NOMINATION FORMS

LOCAL GOVERNMENT REGIONAL NAIDOC AWARDS

23 JULY 2016WIN ENTERTAINMENT CENTRE

WOLLONGONG

2016

LOCAL GOVERNMENT REGIONAL NAIDOC AWARDS 2016Award Categories:Aboriginal Young Achiever of the Year - Male/FemaleAboriginal Community Volunteer of the Year (unpaid worker)Aboriginal Elder of the Year - Male/FemaleOutstanding Contribution to Reconciliation by an Aboriginal or Non Aboriginal PersonAboriginal Organisation of the YearAboriginal Worker of the Year

2016

Details of person nominated

Name:

Address:

Contact No:

Email:

Selection Criteria The Selection Panel will assess nominations on the following selection criteria. Please ensure your application addresses each criterion on the following page. • Demonstrated excellence as a Young Achiever• Demonstrated achievements in leadership and

as an inspirational role model for Aboriginal* people and peers within their communities

• How has the nominated person demonstrated engagement within their local community?

• Must be aged between 12 and 24 years of ageYour responses to the criteria must relate to achievements from the past 12 months only.

This person is:

Aboriginal

Torres Strait Islander

Young Achiever of the year is:

Male Female Age:

This person resides in the following Local Government Area:

Wollongong Kiama

Shellharbour Shoalhaven

Guidelines For Eligibility The purpose of the Award is to acknowledge the contributions and achievements of local Aboriginal and Torres Strait Islander people. To be eligible for the nomination of an Award, the nominee must: • Be an Aboriginal and/or Torres Strait Islander person, and • Live, work or study locally, or be actively involved within their communities.

Note: Aboriginal* inclusive of Torres Strait Islander people.

Details of person lodging nomination

Name:

Address:

Contact No:

Email:

Relationship to Nominee:

Award Category - Young Achiever of the Year

Entries Close: Close of business 24 June 2016The Awards will be presented on Saturday 23 July 2016 at the Regional NAIDOC Awards Dinner at the Win Entertainment Centre, Wollongong.

2016

NOMINATION FORMABORIGINAL YOUNG ACHIEVER OF THE YEAR MALE/FEMALE

Nominations to be returned to:

your council, your community

Email: [email protected] or Fax: 02 4221 6016 Any further enquiries call (02) 4221 6007

Please ensure you address each selection criteria using examples from the past 12 months only. A committee will assess this nomination based on the information provided. Please use additional paper if required.

Name of Nominee:

1. Demonstrated excellence as a Young Achiever (500 words or less).

2. Demonstrated achievements in leadership and as an inspirational role model for Aboriginal* people within their communities (500 words or less).

3. How has the nominated person demonstrated engagement within their local community? (500 words or less)

NOMINATION FORMABORIGINAL YOUNG ACHIEVER OF THE YEAR MALE/FEMALE


Name:

Address:

Contact No:

Email:

Selection Criteria The Selection Panel will assess nominees on the following selection criteria. Please ensure your application addresses each criterion on the following page. • Demonstrated achievements in their voluntary role• How has the nominee demonstrated

commitment to the betterment of Aboriginal people in their voluntary role

• How has the nominee promoted understanding and awareness of Aboriginal culture to the wider community?

Your responses to the criteria must relate to achievements from the past 12 months only.

This person is:

Aboriginal



Wollongong Kiama





Name:

Address:

Contact No:

Email:


Award Category - Community Volunteer of the Year (unpaid worker)


2016

NOMINATION FORM ABORIGINAL COMMUNITY VOLUNTEER OF THE YEAR (UNPAID WORKER)





Name of Nominee:

1. Demonstrated achievements in their voluntary role. How has the nominated person been an outstanding Community Representative? (500 words or less)

2. How has the nominee demonstrated commitment to the betterment of Aboriginal people in their voluntary role? (500 words or less)

3. How has the nominee promoted understanding and awareness of Aboriginal culture to the wider community in their voluntary role? (500 words or less)

NOMINATION FORM ABORIGINAL COMMUNITY VOLUNTEER OF THE YEAR (UNPAID WORKER)


Name:

Address:

Contact No:

Email:

Selection Criteria The Selection Panel will assess nominations on the following selection criteria. Please ensure your application addresses each criterion on the following page.• Demonstrated achievements as an Elder • Demonstrated achievements in leadership and as an

inspirational role model for Aboriginal* people within their communities

• How has the nominee demonstrated engagement within their local Aboriginal community and the wider community?

• What has the nominee done within the past 12 months within the Aboriginal and wider community?

This person is:

Aboriginal


Elder of the year is:

Male Female


Wollongong Kiama





Name:

Address:

Contact No:

Email:


Award Category - Elder of the Year


2016

NOMINATION FORM ABORIGINAL ELDER OF THE YEAR MALE/FEMALE




Please ensure you address each selection criteria. A committee will assess this nomination based on the information provided. Please use additional paper if required.

Name of Nominee:

1. Demonstrated achievements as an Elder (500 words or less).

2. Demonstrated achievements in leadership and as an inspirational role model for Aboriginal* people within their communities (500 words or less).

3. How has the nominee demonstrated engagement within their local Aboriginal community and the wider community? (500 words or less)

4. What has the nominee done within the past 12 months within the Aboriginal and wider community? (500 words or less)

NOMINATION FORM ABORIGINAL ELDER OF THE YEAR MALE/FEMALE


Name:

Address:

Contact No:

Email:

Selection Criteria The Selection Panel will assess nominations on the following selection criteria. Please ensure your application addresses each criterion on the following page. • Demonstrated achievements of the Aboriginal organisation• How has the nominated Aboriginal organisation

demonstrated commitment to the betterment of Aboriginal* people through service provision?

• Demonstrate how the nominated Aboriginal organisation promotes understanding and awareness of Aboriginal Culture to the wider community through their services?

Your responses to the criteria must relate to achievements from the past 12 months only

This organisation is in the following Local Government Area:

Wollongong

Kiama

Shellharbour

Shoalhaven

Guidelines For Eligibility The purpose of the Award is to acknowledge the contributions and achievements of local Aboriginal and Torres Strait Islander people. To be eligible for the nomination of an Award, the nominee must: • Be an Aboriginal organisation, and• Be located within one of the Local Government Areas listed



Name:

Address:

Contact No:

Email:


Award Category - Aboriginal Organisation Of The Year


2016

NOMINATION FORMABORIGINAL ORGANISATION OF THE YEAR





1. Demonstrated achievements of the Aboriginal organisation (500 words or less)

2. How has the nominated Aboriginal organisation demonstrated commitment to the betterment of Aboriginal* people through service provision? (500 words or less)

3. Demonstrate how the nominated Aboriginal organisation promotes understanding and awareness of Aboriginal Culture to the wider community through their services? (500 words or less)

Name of Organisation:

NOMINATION FORM ABORIGINAL ORGANISATION OF THE YEAR


Name:

Address:

Contact No:

Email:

Selection Criteria The Selection Panel will assess nominees on the following selection criteria. Please ensure your application addresses each criterion on the following page. • Demonstrated achievements to reconciliation• How has the nominee demonstrated commitment

to the betterment of Aboriginal* people through reconciliation?

• How has the nominee promoted understanding and awareness of Aboriginal Culture to the wider community through reconciliation?

This person is:

Aboriginal


Non-Aboriginal


Wollongong Kiama


Guidelines For Eligibility The purpose of the Award is to acknowledge the outstanding contributions to Reconciliation. Nominations for this Award can be either Aboriginal* or non-Aboriginal. To be eligible for the nomination of an Award, the nominee must: • Reside within one of the local government areas listed.



Name:

Address:

Contact No:

Email:


Award Category - Outstanding Contribution to Reconciliation


2016

NOMINATION FORMOUTSTANDING CONTRIBUTION TO RECONCILIATION BY AN ABORIGINAL OR NON ABORIGINAL PERSON




Please ensure you address each selection criteria. A committee will assess this nomination based on the information provided. Please use additional paper if required.

Name of Nominee:

1. Demonstrated achievements to reconciliation (500 words or less).

2. How has the nominee demonstrated commitment to the betterment of Aboriginal* people through reconciliation? (500 words or less).

3. How has the nominee promoted understanding and awareness of Aboriginal Culture to the wider community through reconciliation? (500 words or less)

NOMINATION FORMOUTSTANDING CONTRIBUTION TO RECONCILIATION BY AN ABORIGINAL OR NON ABORIGINAL PERSON


Name:

Address:

Contact No:

Email:



Name:

Address:

Contact No:

Email:


Award Category - Worker Of The Year


Selection Criteria The Selection Panel will assess nominations on the following selection criteria. Please ensure your application addresses each criterion on the following page. • Demonstrated achievements in their field of work• How has the nominees demonstrated a commitment

to the betterment of Aboriginal* people within their field of work?

• How has the nominee promoted understanding and awareness of Aboriginal culture to the wider community

Your responses to the criteria must relate to achievements from the past 12 months only

This person is:

Aboriginal


This Organisation is in the following Local Government Area:

Wollongong Kiama


Guidelines For Eligibility The purpose of the Award is to acknowledge the contributions and achievements of local Aboriginal and Torres Strait Islander people. To be eligible for the nomination of an Award, the nominee must: • Be an Aboriginal and/or Torres Strait Islander person, and • Live, work or study locally, or be actively involved within their communities

2016

NOMINATION FORMABORIGINAL WORKER OF THE YEAR





1. Demonstrated achievements in their field of work (500 words or less)

2. How has the nominee demonstrated a commitment to the betterment of Aboriginal* people within their field of work? (500 words or less)

3. How has the nominee promoted understanding and awareness of Aboriginal culture to the wider community? (500 words or less)

Name of Organisation:

NOMINATION FORMABORIGINAL WORKER OF THE YEAR

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