Sunday Territorian 15 May 2011
Sunday Territorian; NewspaperNT
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Community newspapers -- Northern Territory -- Darwin.; Australian newspapers -- Northern Territory -- Darwin.
Nationwide News Pty. Limited
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Nationwide News Pty. Limited
58 Sunday Territorian, Sunday, May 15, 2011 www.sundayterritorian.com.au P U B : N T N E W S D A T E : 1 5 -M A Y -2 0 1 1 P A G E : 5 8 C O L O R : C M Y K prideofaustraliamedal2011 NOMINATION FORM prideofaustralia medalcategories 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, who through his or her act/s of courage have over-ough his or her act/s of courage have overough his or her act/s of courage have over come 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, defence forces, 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, or a member of the medical professions 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 education community, or a role model whose compassion and wisdom while teaching, coaching and mentoring our youth 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 community involvement, hard work and willingness to embrace their new home. 2 0 1 1 P R I D E O F A U S T R A L I A nominators details (Your details) You may nominate more than one person. To nominate someone else, please use a separate form. Title: Mr Mrs Ms Other ___________ Surname: ____________________________________ First Name:__________________________________ Street Address:______________________________________________________________________________ Town/City ___________________________________ State: ________________ Postcode: ___________ Email: _____________________________________________________________________________________ Phone: (H) ___________________________________ (W) __________________________________________ Mobile: _____________________________________ 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 prideofaustraliaaustraliaaustralia medal. Please tick this box to confirm you have read the Rules of Entry. Signed:______________________________________ Date: ____________________________ (nominator) In at least 200 words tell us about your nominee and why they deserve a prideofaustraliaaustralia medal. Tell us how their actions or contribution meets the criteria of the nominated category and how they have inspired you. Please write or type on a separate A4 sheet of paper and attach it firmly to this form. prideofaustraliaaustralia medal categories (Please tick the appropriate category box for your nominee. You may only select one category): Please tick this box if you are nominating two or more people in the Outstanding Bravery, Community Spirit, Heroism, Care and Compassion or Environment categories. (Please attach additional nominees on a separate piece of paper.) Outstanding Bravery Care and Compassion Courage Child of Courage Environment Young Leader Fair Go Community Spirit Heroism Inspiration nominees details (Details of the person or group you are nominating. Please provide as much information as possible). Title: Mr Mrs Ms Other _____________ Surname: ____________________________________ First Name:__________________________________ Date of Birth:_________________________________ (If not known approximate age) Is the nominee an Australian Citizen? Yes No Not sure Nominees country of birth (if known): ____________________________________________ Street Address (or postal address): Town/City: State: Postcode: Phone: (If known) (H) __________________________ (W) __________________________________________ Mobile: _____________________________________ NOMINATIONS CLOSE 5PM, TUESDAYAA , JYY UNE 21, 2011. Send the completed form and additional documentation to: Pride of Australia Medal 2011, GPO Box 1401, 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 on the website listed above. Nominate online today at www.prideofaustralia.com.au You Tube Celebrate an unsung hero today Nominations for 2011 Pride of Australia are now open. If you know an unsung hero that should be recognised nominate them today. For more details, pick up your copy of the NT News or Sunday Territorian or visit www.prideofaustralia.com.au MIA BRAHIM - Child of Courage Pride of Australia Medal recipient for caring for her young brother who has a severe disability.
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