2024 Newcastle Volunteer Service Award Nomination Form

Please submit all nominations by Friday 26 July 2024

Please note - Volunteer's residential address or nominating organisation must be within the Federal electorate of Newcastle to meet eligibility criteria (please refer to THIS MAP for an overview of electorate boundaries).

Question Title

* 1. Volunteer's Details

First name

Last name

Address

Suburb

Postcode

Daytime Contact

Email

Question Title

* 2. Nominator's Details

First name

Last name

Address

Suburb

Postcode

Daytime Contact

Email

Question Title

* 3. Organisation/Club Details (if applicable)

Name of Organisation/Club

Role of Nominee at Organisation/Club

Address

Suburb

Postcode

Daytime Contact

Email

Question Title

* 4. Describe why this volunteer has been nominated (minimum 250 words).
Please include how long the nominee has been volunteering and their role.