AUSTRALIA INDONESIA AWARDS 2019 NOMINATION FORM
To recognise and honour those who have made significant contributions to the greater understanding and friendship between Indonesians and Australians.
Nominations close 28 February 2019. Nominations will be reviewed by an independent Selection Panel, chaired by Mr Bill Farmer, former Ambassador to Indonesia. Three Finalists in each category will be announced in May 2019, and the winner in each category will be announced at the Awards Presentation in July 2019.
AUSTRALIA INDONESIA ASSOCIATION
Australia Indonesia Awards Presentation Video
CATEGORY - Please tick the category for which your nomination is to be entered. *
Required
NOMINEE
(The person you are nominating)
Title (Mr, Mrs, Dr, etc) *
Your answer
First Name *
Your answer
Last Name *
Your answer
Organisation/Position
Your answer
Street Address *
Your answer
City/Suburb *
Your answer
State *
Your answer
Country *
Postcode *
Your answer
Telephone or mobile *
Your answer
Email *
Your answer
Tell us about your nominee: Please provide as much detail as you can and consider the selection criteria. (Extra pages and supporting material may be emailed or posted to address below.) *
Your answer
In what ways have they demonstrated commitment to Australia Indonesia relationships? *
Your answer
In what ways could they be a role model for others? *
Your answer
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