Australia Day Nomination Form 2026 - Community Organisation of the Year

Section 1 - Nominee Details

Name of organisation *

Main activity/Purpose *

Organisation street address

Street address

Suburb/locality

State

Postcode

Nominee phone number

Nominee email address

Please indicate In what region of Queanbeyan-Palerang the organisation is nominate for: *

Braidwood regionBungendore regionCaptains Flat regionQueanbeyan region

Section 2- Nominator and Seconder Details

This community organisation is nominated by

Nominator name *

Organisation (if applicable)

Nominator street address

Street address

Suburb/locality

State

Postcode

Nominator Phone number *

Email Address *

What is the nominator's relationship to the organisation? *

Nominator signature *

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Date *

Please provide details of a seconder for this nomination who we can contact to verify the nomination.

Seconder full name *

Seconder organisation (if applicable)

Seconder phone number *

Seconder email address *

What is the seconder's relationship to the event? *

Section 3 - Reasons for Nomination

Please refer to Eligibility in Section 4.

Describe the nominated organisation and why it should be considered for the award. *In 150-250 words, summarise the purpose of the organisation, details and activities, objectives and achievements, if the organisation is non-for- profit or not, and why you are nominating it for the award. Please note that this text may be used in the selection process and used for promotional purposes.

Please use some examples to demonstrate the reach of the organisation in the community and why it is particularly beneficial in the last 12 months. *In 150-250 words, provide examples which may include how many people in the community benefited and in what way, what members were involved/included, level of reach, impact on community i.e social, economic, etc.

Please provide some background information about your nominee.Not to exceed 150 words. Examples may include previous awards received, history and length of service, indication if work/service was paid or voluntary, etc.

Add any attachments that support your submission

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Not essential - Max 4 attachments. Any relevant documentation e.g. media coverage, photos, articles, testimonials, etc.

Section 4 - Eligibility

A community organisation/event who has won an Australia Day Award in the past is not eligible to be considered for nomination again. The person/group nominated must be all be Australian Citizens. The organisation/event must have taken place in the Queanbeyan-Palerang region.

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