Northern Territory Community Achievement Awards
Nominations are NOW OPEN!

Please complete the details below for the individual/group/organisation/business you would like to nominate and we will get in contact with them and have them complete the official online nomination form.

Terms & Conditions
Nominees must be residing in the Northern Territory (for a minimum of 2 years) or the nomination activity must be specific to the Northern Territory.
Your Details
Would you like to remain anonymous to the nominee? *
Please note: we require your details for our records, but if you select 'Yes' your details will not be visible to the nominee.
Full Name *
Company Name
Email Address *
Phone Number *
Nominee Details
Nominee Company/Group - If Applicable
Nominee Full Name *
Nominee Email Address *
Nominee Phone Number *
Category you wish to nominate them into *
How did you come across this form? *
Why would you like to nominate this person?
It's optional...but if you can spare a few more minutes we would love to know why you would like to nominate this person/business (1-2 sentences is fine).
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy