Nominee Form - NSW Environmental Citizen of the Year Award

Please complete the below information by Wednesday 23 March, 2022. If you have any questions, please contact the Australia Day Community Programs team on 02 9228 5188 or [email protected].

To assist the selection panel in assessing your nomination and the NSW Department of Premier and Cabinet in promoting your initiative, please respond to the questions below. Please note some questions refer to information provided to you via email.

With your approval, your responses may be used for promotion in print and social media channels, media releases, on the Australia Day Council of New South Wales website and NSW Government and Return and Earn websites.

Selection Panel

The NSW Environmental Citizen of the Year Award winners will be selected by a panel made up of representatives from the NSW Department of Premier and Cabinet and the Return and Earn Scheme. The panel will make the final decision on award recipients based on the information provided in the nomination form and additional questions provided to nominees.

Category

Which category do you belong in?

Nominee Biography

Our team has prepared a short biography to showcase your nomination and have provided this to you via email, the same email where you found the link to this page.

Maximum 2500 characters

About your initiative

Maximum 2500 characters
Maximum 2500 characters
Maximum 2500 characters
Maximum 2500 characters

Do you have any relevant images of your initiative that you would like to share with us?

You can add up to 4 images. Please ensure these are high resolution.

Maximum size: 5MB
Maximum size: 5MB
Maximum size: 5MB
Maximum size: 5MB

Assessing your initiative

To assist the selection panel in assessing your nomination, the NSW Department of Premier and Cabinet will provide the panel with your approved biography and responses to the questions above, including images and videos you have uploaded. Please note your approval below:

Please note your approval

Promotion of your initiative

The NSW Department of Premier and Cabinet and Australia Day Council of NSW would like to showcase your environmental initiative using information you and your nominating LGA have provided. This includes:

  • Your approved biography
  • Responses to the questions above, including images you have uploaded
  • Images and videos provided by your nominating LGA (if applicable, these have been emailed to you for your reference, in the same email where you found the link to this page)

With your approval, the NSW Department of Premier and Cabinet may share this information:

  • On the Australia Day Council of New South Wales website and NSW Government and Return and Earn websites
  • With local media including local newspapers and radio
  • Through media releases, print and social media channels
Are you happy for the NSW Department of Premier and Cabinet and Australia Day Council of NSW to showcase your initiative and share this information with media?

Contact

Local newspapers or radio stations may wish to contact you for a quote, additional information on your initiative or to arrange for photographs to be taken. Are you happy for your contact details to be shared with media to contact you directly?

Terms and Conditions

The winners of the NSW Environmental Citizen of the Year Award and NSW Young Environmental Citizen of the Year Award will be offered a one-off conditional donation (of $3,000 and $1,000 respectively) to contribute towards the cost of their environmental initiative. Winners must use the prize money towards their community initiative.

By submitting this nomination, you grant permission for information, including summaries, photos and videos prepared or taken by you, to be used as part of case studies or promotional material for future NSW Government environmental initiatives such as the Return and Earn Scheme. 

The Department requests your personal information to facilitate the assessment of your nomination by the selection panel, for promotional purposes and for evaluation and reporting of the awards program. The Department may provide your information to the selection panel and other program stakeholders and partners (including NSW Environmental Protection Authority, TOMRA Cleanaway and Exchange for Change) for the purposes of assessing nominations and awarding winners. If you have agreed, the Department may share nominee information online, to media, with the Chair of the Australia Day Council of NSW, the Office of the NSW Premier and the Office of the NSW Minister for Energy and Environment for promotional purposes.

The Department will not disclose nomination information to anybody else unless required to do so by law. You are not required to provide the requested information, however not providing the requested information may impact the Selection Panel’s ability to properly assess your nomination, and limit or prohibit the promotion of your nomination. You may request access to your personal information held by the Department by contacting the Department’s Information Access and Privacy Unit.

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