Australia Day Nomination Form

  • Nominee Details

  • (The person or event you would like to nominate)
  • Accepted file types: png, jpg, pdf, gif, word.
    Upload File 1 (Please note only PDF, Word Doc, png, Docx or JPEG files will be accepted)
  • Accepted file types: png, jpg, pdf, gif, word.
    Upload File 2 (Please note only PDF, Word Doc, png, Docx or JPEG files will be accepted)
  • Nominator's Details

  • (Name of person making the nomination)
  • Referee Details

  • Final Checklist

  • Privacy Collection Statement: Devonport City Council collects personal information for municipal purposes. The information collected in this form is used only for the purpose specified (primary purpose) and is not passed on to third parties. Council may disclose this information only if authorised or requested by law. Council may not be able to process your request unless sufficient information is given. Should you need to change or access your personal details, or you require further information about Council's Privacy Policy please contact Council's Privacy Officer.

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