Details of Nominated Young Person
First Name
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Last Name
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Email Address
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Contact number
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Age
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12
13
14
15
16
17
18
School Year
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7
8
9
10
11
12
Name of school, association or sporting club
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Suburb the young person lives in
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Details of Nominator (if same as above, please leave empty)
Nominator name
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Nominator email address
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Nominator contact number
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Relationship to nominee
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Nomination
Please pick the category you are applying for:
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Leadership
Inspiration
Academic Achievement
Community Involvement
Creative and Performing Arts
Sporting
In 250 words or less, please describe why your nominee deserves to win the award
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Supporting documents and pictures (optional)
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