This entry form is for the individual award categories. There is a separate entry form for the care facility award categories.

ENTRIES MUST BE RECEIVED BY 5:00PM FRIDAY 30 AUGUST 2024. Applications received after this time will not be considered.

Click here to view the Award Criteria Booklet 2024.
ENTRY FORMAT
  • This award entry consists of mostly written responses, however visual materials (photos or videos) are also required.
  • As these materials may be shared on our social media platforms, please ensure that everyone featured has consented to its use. We can provide a consent form template if required.
  • Visual materials can be supplied via email, Dropbox, or WeTransfer.
  • Entries MUST be submitted via this form. Entries not submitted on these forms will not be considered.

  • Please note that all material sent in support of your entry will become the property of the NZACA and may be used by the NZACA for the purpose of preparing cases studies, which may in turn be used by the NZACA at any time for the purposes of publicity (e.g. social media). By submitting your entry, you consent to releasing this material to the NZACA.

  • The NZACA will provide appropriate safeguards for the storage, use and disclosure of this information in accordance with the Privacy Act. You may request your information or material at any time from the NZACA.
APPLICATION PROCESS
1. Once all entries are received, they will be judged by one of three judging panels.

2. Two finalists will be agreed upon by the judges for each category.

3. All finalists will be notified of the outcome of their entry by 27 September 2024.

4. Following the completion of all judging, the judging panels will convene to decide on winners of each category and the overall winner.

5. Category winners and the overall winner will be announced at the NZACA Awards Ceremony on Tuesday 22 October at the Viaduct Events Centre, Auckland.
INDIVIDUAL AWARD CATEGORY

Question Title

* 1. Individual Award Category
Only ONE category may be entered on each entry form, but you may submit more than one entry form to enter into different categories.

NOMINATION INFORMATION
Details of the person being nominated:
Note: Individuals can nominate themselves.

Question Title

* 2. Name:

Question Title

* 3. Position:

Question Title

* 4. Care facility associated with:

Question Title

* 5. Contact number:

Question Title

* 6. Contact email:

Details of the nominator:
If different to above.

Question Title

* 7. Name:

Question Title

* 8. Position:

Question Title

* 9. Care facility associated with:

Question Title

* 10. Relationship to nominee:

DETAILS OF ENTRY

Question Title

* 11. TITLE
Please give your entry a title that is descriptive of the entry:

Question Title

* 12. SYNOPSIS OF ENTRY
Please give brief description of the person being nominated and why they are being nominated. This may be used for promotional purposes.

Please write no more than 100 words.

Question Title

* 13. THE NOMINEE
Describe why the nominee should be considered for this award.

Consider how the individual has impacted on the quality of life of the resident(s) and their families and staff.

Please include examples.

Please write no more than 400 words.

VISUAL MATERIALS

Question Title

* 14. How will you be supplying your visual materials?

Question Title

* 15. For those providing content via link, Enter URL/Link here:

DECLARATION

Question Title

* 16. Declaration

T