Online Form - Citizen of the Year Awards Nominations Form

Please provide as much information as possible. Additional documents may be attached providing further information of testimonials of achievement.

Award Category *
Nominee Address
Is the person being nominated an Australian citizen? *
Maximum size of ALL attachments is 976.56 MB
Nominator Address
I give permission for the Australia Day Council NT to submit this nomination to other recognition programs such as the Australian of the Year Awards *