seniors awards 2012 - Townsville City Council

townsville.qld.gov.au
  • No tags were found...

seniors awards 2012 - Townsville City Council

seniors awards 2012nomination formRecognising seniors for theirachievements and contributionsto our community


Award presentations will be held during the Townsville City Council’s Seniors Picnic in the Park and Lifestyle Expo tobe held in Sherriff Park, Mundingburra, on Wednesday 22 August 2012 from 10am – 1.30pm.how to nominate a volunteer >>The Townsville City Council Seniors Awards are open to people aged over60 who have voluntarily given their time for the good of the TownsvilleCommunity.The volunteer activities must have occurred within the city of Townsville.To nominate a volunteer, please write between 300 and 600 wordsaddressing the selection criteria. You can use the dot points provided undereach criteria as a guide. Your nomination should be a total of about onepage of typed, single spaced writing, or two full handwritten pages. Pleasetype or write your response on a separate sheet/s of paper attach to thenomination form.eligibility >>• You can nominate any permanent resident of Townsville aged 60 years orover as at 31 July 2012• You can not nominate yourself.important notes >>The Townsville City Council selection committee is unable to considernominations that do not meet the following:1. The nominated person must be 60 years of age or over as at 31 July 2012.2. The activities for which they are being nominated must have been carriedout in a voluntary, unpaid capacity.3. The voluntary activities must have occurred in the City of Townsville.4. Individuals cannot nominate themselves for a Townsville City CouncilSeniors Award.5. Only an individual can submit the nomination. An individual may submita nomination on behalf of an organisation.6. The nomination form must be completed in full.Your responses to the Selection Criteria tell the selection committee whyyour nominee deserves an award.selection criteria >>1. Significant contribution to the communityHow has the nominee made a significant contribution to the TownsvilleCommunity?You should include:• Information about the fields or areas in which your nomineevolunteers• Information about the organisation/s your nominee volunteers for,and their role in the organisation/s• An example/s of how the nominee has made a difference to theTownsville Community2. Demonstrated commitment to volunteering in the City of TownsvilleHow has the nominee shown commitment and dedication tovolunteering?You could include:• Examples of the time or resources your nominee has dedicated totheir community or organisation/s• An example/s of challenges your nominee has overcome3. Demonstrated impact of the volunteer activities on the TownsvillecommunityWhat is the impact of the nominee’s volunteering activities?You should include:• Specific examples of the positive impact your nominee has had onindividuals or the Townsville community• Information about the importance of the volunteer work yournominee doesNominators please remember to list all organisations and details of thework undertaken for nominees, not just the work for your organisation.7. A separate nomination form must be completed for each nominee.8. Entries must be submitted in writing.9. Current members of the selection committee will not be considered for aTownsville City Council Seniors Award.10. Nominations must contain contact details for the nominee, nominatorand two referees.11. The nominator must know the nominee.12. You may nominate a family member.13. A referee cannot be a family member of the person nominated or thenominator.14. You cannot nominate someone and act as their referee.15. Make sure you address each of the three selection criteria. Give examplesfor each criterion so the selection committee knows the impact yournominee has had in the Townsville community.16. Responses must not exceed a total of 600 words.17. Use the dot points under each criteria as a guide.18. Provide your written response to the selection criteria on a separatesheet/s of paper, and make sure it is either typed or neatly written.19. Copies of information such as citations, media clippings or photographsmay be attached to the nomination form to support your nomination butcannot be returned.20. The selection committee’s decision on 2012 Townsville City CouncilSeniors Awards winner is final.submitting your nomination >>mail:Seniors AwardsTownsville City CouncilCommunity ServicesPO Box 1268Townsville Qld 4810in person:Community Development,Level 1, Northtown, 280 Flinders Street, Townsvilleemail:seniors@townsville.qld.gov.auNominations sent by fax will not be accepted.Nominations mustbe received by 5pmFriday 3 August 2012For enquiries or more information, please contact Community Developmenton 1300 878 001 or visit www.townsville.qld.gov.au


nomination formtownsville city councilseniors awards 2012details of person being nominated >>Title: (Mr/Mrs/Ms/Miss)______________ First Name:__________________________ Surname:_____________________________Residential Address:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Postal Address:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Telephone Number: Home________________________________ Work____________________________ Mobile__________________________Date of Birth (mandatory):_____ /______ /_________Is date of birth provided exact or estimated (please tick): Exact EstimatedIs the person being nominated aware of this nomination? (please tick): Yes NoIs the person willing to accept an award? (please tick): Yes No(Please note, if ‘no’ is indicated in this question, this person cannot be nominated)details of person submitting this nomination >>Title: (Mr/Mrs/Ms/Miss)______________ First Name:__________________________ Surname:_____________________________Residential Address:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Postal Address:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Telephone Number: Home________________________________ Work____________________________ Mobile__________________________If submitting this nomination on behalf of a group or organisation, please state organisation’s name:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature:______________________________________________Date:____________________________privacy noticeThe Townsville City Council is collecting the information on this form to assess and administer your nomination for the Seniors Awards. Your nomination formcannot be processed without this information. Council may disclose your personal information if legislation allows or requires this, or where you have given yourpermission. The council usually gives some or all of this information to the selection committee members. Where selection committee members are external tocouncil they are required to protect your personal information and not disclose it without your permission.Please provide details of the nominee’s voluntary work and contribution to the community onseparate sheet/s and attach to this nomination form.


nomination formreferees >>townsville city councilseniors awards 2012Please provide the details of two referees who are familiar with the nominee’s volunteer work. We may contact the referee/s for further information about thevolunteer work of the nominee.Referees cannot be:• the nominator,• a family member of the nominee or• a family member of the nominatorREFEREE 1Title: (Mr/Mrs/Ms/Miss)______________ First Name:__________________________ Surname:_____________________________Position/Organisation (optional):____________________________________________________________________________________Suburb/Town:___________________________________________________________Postcode:____________________________Position/Organisation (optional):____________________________________________________________________________________Telephone: Home______________________________ Work__________________________ Mobile_______________________________Email:___________________________________________________________________________________________________________Relationship to Nominee:___________________________________________________________________________________________Signature of Referee (mandatory):____________________________________________________________________________________REFEREE 2Title: (Mr/Mrs/Ms/Miss)______________ First Name:__________________________ Surname:_____________________________Position/Organisation (optional):____________________________________________________________________________________Suburb/Town:___________________________________________________________Postcode:____________________________Position/Organisation (optional):____________________________________________________________________________________Telephone: Home______________________________ Work__________________________ Mobile_______________________________Email:___________________________________________________________________________________________________________Relationship to Nominee:___________________________________________________________________________________________Signature of Referee (mandatory):____________________________________________________________________________________checklist >>Before submitting, please carefully check this nomination and ensure that each box is ticked ( P ) to ensure that you have fully completed and enclosed all of therequired information with this nomination.All details for the nominee have been completed.All details for the nominater have been completed.All details for the two referees have been completed.The person that you are nominating is aged 60 years or older.The person that you are nominating is a permanent resident of Townsville.The referee is not a family member of the nominator or nominee.The nominee’s activity has been on a voluntary basis within the city of Townsville.You have responded to each selection criteria.Your response to the selection criteria is more than 300 words, is not more than 600 words, is on a separate page/s and has been attached to the nomination form.Your response to the selection criteria is typed or handwritten.This nomination addresses all of the criteria and provides enough information to be considered for an award by the Townsville City Council.The information contained in this nomination is true and correct.The person being nominated is aware of this nomination and would be willing to accept an award.

More magazines by this user
Similar magazines