2021
Australia Day
Awards
NOMINATION FORM Australia Day Awards recognise and honour the outstanding achievements of Australians and celebrate excellence ( either a person or an organisation ) who have made an outstanding contribution to the communities of the Brewarrina Shire during 2020 . Nomination are now OPEN for you to nominate either a person or an organisation who YOU believe should be recognised for their contribution or achievements in 2020 . An independent committee will assess the applications and Council will announce the winners at its Australia Day Ceremony , held on Tuesday 26th of January 2021 at the Brewarrina Memorial Swimming Pool .
NOMINATIONS CLOSE AT 5pm Wednesday 16TH DECEMBER 2020
I would like to nominate :_______________________________________________________________________ Address : ________________________________________________ Contact Phone # _____________________ The categories are : ( Please tick one ) Citizen of the Year ( 26 years and over on the 26th January 2021 )
Recognises outstanding members of the community for their personal endeavours , achievements and community involvement .
Young Citizen of the Year ( 25 years and under on the 26th January 2021 )
Recognises young citizens for their personal endeavours , achievements and community involvement .
Sportsperson of the Year ( 26 years and over on the 26th January 2021 )
Recognises a sportsperson , coach , administer or official whose actions inspire and encourage others and enrich the community through sport .
Young Sportsperson of the Year ( 25 years and under on the 26th January 2021 )
Recognises a young sportsperson , coach , administer or official whose actions inspire and encourage others and enrich the community through sport .
Australia Day Award Recognises individuals or groups whose actions inspire and encourage others and enrich the community .
A provide a brief statement , containing no less than 50 words , listing the nominee ’ s achievements , using this form or by attaching additional pages to this form .
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All nominations are to be addressed as “ Confidential - Australia Day Awards ” and must be received by 5pm on Wednesday the 17th of December 2020 . Nominations can be hand delivered to Council ’ s front office at 57 Bathurst Street , Brewarrina , sent by e-mail to breshire @ brewarrina . nsw . gov . au or posted to PO Box 125 Brewarrina NSW 2839
Your Details - Name : ______________________________________ Contact Phone # _______________ Signature : ________________________________________________________________________