Australia Day Nomination Form

Australia Day Nomination Form

Do you know someone who makes our community a better place?

Longreach Regional Council’s Australia Day Awards celebrate the achievements and contributions of individuals and organisations in our Region. The awards are an opportunity to publicly acknowledge those who have made an extraordinary contribution or are outstanding achievers. If you know of a person or community group dedicated to making the Longreach Region a better place, please help us recognise their efforts and nominate them for an Australia Day Award.

There are five categories for Australia Day awards:

Award Category	Description
Citizen of the Year	To recognise an individual who has made a significant contribution to the development of their community, and/or given outstanding service to their community during the past year or, over a number of years.
Senior Achievement (18 years or older)	To recognise an individual (participant, coach, official, administrator) or a team, who has made a noteworthy contribution to the cultural or sporting life of their community or has attained an outstanding achievement in a cultural or sporting activity.
Junior Achievement (Under 18 years)	To recognise an individual (participant, coach, official, administrator) or a team, who has made a noteworthy contribution to the cultural or sporting life of their community or has attained an outstanding achievement in a cultural or sporting activity.
Local Legend – Individual	To recognise an individual in each community who has contributed significantly to the social, economic, sporting or cultural life of their community.
Local Legend – Organisation	To recognise an organisation or event in each community that has contributed significantly to the social, economic, sporting or cultural life of that community.

Judging Process

Nominations will be reviewed by the appointed judging panel. The judge’s decision is final and no correspondence will be entered into.

Eligibility

Nominees must reside within the Longreach Regional Council area.
Community events must be held within the Longreach Regional Council area.
Nominees cannot have won an award in the same category in the last three years.
The Citizen of the year award is recognised as a lifetime achievement award.
Current elected members are not eligible for nomination.
Recognising exceptional contributions through paid work:

While Australia Day awards often celebrate voluntary service, it’s encouraged for individuals to be nominated based on their paid employment when their impact extends beyond the expectations of their role. A nomination can be justified when an individual:

Consistently exceeds the scope of their paid duties: They demonstrate initiative, leadership, or innovation that significantly enhances their workplace or sector.
Creates positive change in the community: Their work benefits not just their organisation but also the broader public—through advocacy, outreach, education, or support.
Demonstrates sustained commitment and excellence: Their contributions are not one-off but reflect a long-term dedication to improving lives or systems.
Acts with integrity and compassion: They embody values that inspire others and foster a culture of care, inclusion, and service.

In essence, the awards recognise impact, not just position. If someone’s paid role becomes a platform for extraordinary service to others, they are a worthy candidate.

AWARD CATEGORY
Award Categories*
Category Selected
NOMINEE DETAILS
Which town is the nominee being considered from?*
Nominee Name*

First NameLast Name
Team Name
Nominee Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Nominee Contact Number*
Please enter a valid contact number.
Nominee Email*
example@example.com
What town within the LRC is the organisation or event based out of? *
Organization Name*
Event Name
Is the nominee under 18 years of age?*

YesNo

NOMINATION JUSTIFICATION
What area has the nominee provided excellence in?*

AcademicsSportsArtCulture
Provide evidence of significant accomplishments, recognition, or contributions that highlight the nominee’s commitment, talent and impact in their chosen area(s)?*
How is the nominee an inspirational role model for the community?*
What impact has their achievements had on the community? *
Describe how the nominee is an inspirational role model and displays continued excellence in their field and in the community.
Provide detailed examples of how the nominee has demonstrated a significant and outstanding contribution to the community.
Explain how they have contributed their time to the community in the current year or provided outstanding service over a number of years.
How has their contribution been provided on a voluntary basis, or how have they exceeded the normal requirements of their paid work?
Describe the social, cultural and/or economic benefits that the community group or event has brought or will bring to individuals, community organisations, or the community in general.
Provide detailed examples of how the community group or event has built community partnerships.
Explain how the community group has been actively involved in volunteering in a significant way?
Give an example of an outstanding contribution the organization or event has made to the region.
What impact has the nominees contribution had on the community?
Please provide an example of their contribution to the community
ATTACHMENTS
Attachment

Cancelof

NOMINATOR DETAILS
Nominator Name*

First NameLast Name
Nominator Email*
example@example.com
Nominator Phone*
Please enter a valid phone number.
PRIVACY COLLECTION NOTICE
Longreach Regional Council is committed to handling your personal information in accordance with the Information Privacy Act 2009 (Qld) and the Queensland Privacy Principles (QPPs).

QPP 5 obliges us to advise you of certain matters when collecting your personal information. This collection notice sets out those matters, and explains how we will manage the collection, use, disclosure and storage of your personal information.

The information collected is necessary to complete the Australia Day Nomination process including using the contact details provided after the panel has been put in place to contact you.

Your personal information has been collected under authority of the Local Government Act 2009.

If you choose not to provide your name and contact details, we will not be able to process your Australia Day Nomination.

Our privacy policy explains how you may request access to and/or correction of your personal information. Our policy also explains how you can complain to us if you consider we have breached our obligations to manage your personal information in accordance with the QPPs, and how we deal with privacy complaints.

If you have questions regarding how your personal information will be handled contact us at: 07 4658 4111 or email council@longreach.qld.gov.au
Do you agree with the Privacy Collection Notice?*

Yes

***Nominees over 18 years old are not eligible for the {categorySelected} category. You cannot continue with this nomination.
Should be Empty:

Australia Day Nomination Form

AWARD CATEGORY

NOMINEE DETAILS

NOMINATION JUSTIFICATION

ATTACHMENTS

NOMINATOR DETAILS

PRIVACY COLLECTION NOTICE