Lifetime Achievement Nomination Form
Online Entry Form for Esperance NAIDOC 2021

Ensure contact details of the person you are nominating are provided as the Independent team will use these details to make contact with nominated person.

All nominee's will need to be 18 years and Over as the announcements will be made at this years NAIDOC Ball.

Please make sure you leave a detailed description of why you nominated the person in the nominee forms as they will be judged on merit by an independent team.
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If you know of an individual worthy of being recognised as legendary. This Award nomination is open to an individual, a community or a project.  
Please use the following selection criteria to nominate them:

The individual is worthy of being recognised as legendary
Demonstrated leadership
The individual is an inspirational role model for Aboriginal and Torres Strait Islander people and broader Australian society
The individual’s achievements and commitment span many years
Demonstrated community involvement and commitment at the local, regional and national levels
Contribution to developing the Indigenous community at the national level
This Award nomination is open to an individual, a community or a project.
Details of person being nominated
Entrants must be Aboriginal and/or Torres Strait Islander, as defined by the following:
*is of Aboriginal and/or Torres Strait Islander descent.
*identifies as Aboriginal and/or Torres Strait Islander.
*is accepted as such by the community in which he or she lives or has lived.
Nationality *
Required
Gender *
Title *
Name of Nominee *
Age (if known)
Explain how the nominee is an inspirational role model to Aboriginal and Torres Strait Islander people? (minimum of 50 words) *
List the nominee's achievements over the many years. *
How has the nominee made an impact on yourself or the Aboriginal and Torres Strait Islander people? (minimum of 50 words) *
Do you want to add anything further?
Submit
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