Nomination Form
Your Details
* Mandatory fields
Your Nominee
Please provide as much information as possible about the person or group you are nominating.
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Please tell us about your nominee and why they deserve a Pride of Australia medal. Please make specific reference to how their actions and contributions meet the medal criteria and how they have inspired you and your community.*

Metropolitan newspaper
Community newspaper
Direct communication
Social network
Family or friend
Previous nominator
Previous nominee
I do not wish to be identified as the nominator to the nominee.
I do not wish to be contacted in future years in relation to the Pride of Australia medal.
I have read and agree to the Rules of Entry *
I wish to sign up to receive my state newspaper daily e-newsletter.