Nominee Form | Victoria Day Council

The Award Nomination form be filled out below.

If you would prefer to download the form and fill it out, please download it here. Please print the page, complete the details and mail your nomination to the address on the form.

Your Name*
First Last
Your Email*
Your Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Nominee's Name / Organisation Name*
First Last
For Victorian of the Year (the Victoria Day Award for Community and Public Service), Young Victorian of the Year (Victoria Day Award for Community and Public Service by a young Victorian) and Victoria Day Award for a Local Achiever nominate a person (include first and second name of the person). For a community organisation (Victoria Day Award for Community and Public Service by a Victorian Organisation or Association) or social enterprise or socially responsible business (Victoria Day Award to a Good Corporate Citizen) you must nominate an entity (rather than person). A nominee for Victoria Day Award for the Arts can be an organisation or individual. Please consult the list of previous winners contained on this website (this will give you an indication of types or people and organisations that have previously been deemed worthy of receiving an award). For an organisation (not person) simply put the name of the entity in the ‘First' name field (e.g. previous award winner ‘Cabrini Health Australia’) and in the ‘Last’ name field put the full name of the contact person for that organisation (e.g. Cabrini Health CEO 'Sue Williams').
Nominee's Email*
Nominee's Address
Street Address City State / Province / Region ZIP / Postal Code Country
Victoria Day Award category*
Please outline in approximately 500 words why your nominee might be appropriate to receive a Victoria Day Award.
Attach any documents or images
Drop files here or