Youth Community Service Awards - Nomination Form - The Order of Australia Association

High School Principal

Name *

First

Last

Principal of [insert school name] *

Phone *

Email *

School Address *

Address Line 1

Address Line 2

City

State

Post Code

Nominee

Name of Student *

First

Last

Postal Address *

Address Line 1

Address Line 2

City

State

Post Code

Student’s Email Address and Contact Number -see side text (for direct contact and for forwarding photos taken at the award ceremony) *

Phone *

Date of Birth *

Permission to use photos taken at the award ceremony *

Referees

Referee 1:

Name *

First

Last

Phone/Mobile No. *

Occupation *

Referee 2:

Name *

First

Last

Phone/Mobile No. *

Occupation *

Instructions: Please attach a Citation with a distinct description of the community service provided by the student in no more than 1000 words. This must not be written by the student. Nominations must be in pdf format for submission.

Please attach citation - drag the file into the area below or click to upload *

Drag & Drop Files, Choose Files to Upload

***documents should be submitted in pdf format only

Message

Youth Community Service Award 2026

Closing Date for Nominations Is Friday June 5. Late Nominations will not be considered.
Dianne North OAM
Convenor, Youth Community Service Award
The Order of Australia Association (NSW)
Enquiries : [email protected]