ANZAC House, 4 Collins St, Melb Vic 3000 P ANZAC Awards Committee Victoria Chairman: Mr David W Ford CVO AM GM

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Rewarding Australians who show true ANZAC Spirit Nomination Pack 2014 Lieutenant Colonel Michelle Ager Mr George Logan RFD

The AIM To recognise the efforts and achievements of up to seven Australians who have given service to their fellow Australians and to the community in a positive, selfless and compassionate manner. The recipients could range from a surf life saver to a charity worker who has spent years looking after the destitute and impoverished; to a nurse or a mailman. The award recognises the efforts of those who are outstanding even in the pursuit of what might appear to be routine activity. ELIGIBILITY Nominations may be made on behalf of any Australian citizen or any individual who is in the process of obtaining citizenship. The nominee can be male or female of any age. Any individual or group who has demonstrated the spirit of comradeship and selfless service embodied in the tradition of ANZAC is eligible for nomination. Up to seven awards will be presented nationally. THE AWARD The Award is a bronze medallion, four inches in diameter, depicting Simpson and his donkey, presented in a specially designed presentation case. The award is accompanied by a certificate outlining the nature of the award and with the citation on which the nominee was selected. A bronze miniature lapel badge is also presented for everyday wear. PRESENTATION The awards are presented at the RSL s State Conference mid-year.

Award Nomination Form In support of this recommendation I/we supply the following information for:- ANZAC of the Year Nomination forms should be marked Confidential and returned to: The Secretary Victorian Committee for the ANZAC Awards ANZAC House, 4 Collins Street MELBOURNE VIC 3000 Nominations close Tuesday 31 st December 2013

Details of Person Submitting Nomination The following information about the person submitting this recommendation is needed to enable members of the National Selection Committee to seek further details if required: NAME (in full) HOME ADDRESS TELEPHONE (home) OCCUPATION BUSINESS ADDRESS TELEPHONE (business) Details of Person Recommended for an Award Please provide a biographical profile of the person you are nominating by completing the section below and by providing the details requested on the next page. SURNAME CHRISTIAN NAME HOME ADDRESS TELEPHONE (home) OCCUPATION BUSINESS ADDRESS TELEPHONE (business) POST NOMINALS (if applicable) DATE & PLACE OF BIRTH

NATIONALITY

Supporting Documentation Please attach as much information as you can to support your nomination. This must include but is not limited to: Reason for the nomination including reference to the ANZAC qualities displayed by the nominee/s. Important dates should be incorporated where possible but a chronological list of activities is not enough to support the nomination. You must submit as much detail as you can assemble. Please indicate whether the nominee has been in paid employment or has volunteered their time. Please note that those in paid employment are eligible. References from between one and three community leaders supporting the nomination. This may include Local Members of Parliament, Presidents of Clubs, local Council members etc. We would expect at the least a single typed A4 page of information but the more information you can provide, the better.