SA Environment Awards Nomination Form
Please ensure your application meets the relevant Award Criteria:

View all category criteria here:


The recipient shall be chosen by majority vote of the Judging Panel, with the Convenor having a casting vote. SA Environment Awards reserves the right, in any given year, not to issue any Award.

Nomination forms must be submitted by 5pm Tuesday 2 April 2024
Sign in to Google to save your progress. Learn more
Award category nominated (you may apply for more than one category)
*
Required
NOMINEE DETAILS
Name *
Address (including postcode)
Phone
Email
If nominated by someone else:
Name
Title/Position
Address (incl. postcode)
Phone
Email
Is the nominee aware of the nomination?
May we contact your nominee prior to judging?
REFEREE
Please indicate someone who is conversant with the nominee’s achievements and who has agreed to act as a referee for this nomination
Name
Address (incl. postcode)
Phone (daytime)
NOMINATION SUMMARY
(No more than three sentences)

Please provide a snapshot summarising the key points of your nomination statement below (bullet points accepted).
Brief nomination summary:
*
FULL NOMINATION STATEMENT
(No more than 500 words)

Please provide a statement addressing the nominee's achievement/s, qualifications and suitability for the award/s.

This may include: 
Details of a specific achievement (if applicable to the category)
Examples of how the nominee has met the criteria of the award category
The role(s) or area(s) in which they have contributed
The period of time, or dates of service (if known)
Evidence of other awards or recognition received by the nominee (e.g. AM, Order of Australia, etc.)
Any other supporting information

Please note the judges will be basing their decision on the information submitted In this statement - please ensure all details (including name spelling and qualifications) are correct.
Full nomination statement:
*
ACKNOWLEDGEMENT
*
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Conservation Council of SA Inc.. Report Abuse