AUSTRALIA DAY CITIZEN OF THE YEAR AWARDS

Entries for Australia Day Citizen of the Year Awardsclose on Thursday 19 November 2026 by 9.00pm.

Entries submitted after this deadline will automatically be entered into the following year’s Award

To preview a blank nomination form please click here.

Nominee Information

The person or group you are nominating is known as the ‘nominee’. Individuals cannot self-nominate. All questions must be answered, unless marked optional.

Select Award Category *

Young Citizen of the Year: 16 – 30 years oldCitizen of the Year: 31 – 64 years oldSenior Citizen of the Year: 65 years old and overCommunity Group Award in honour of Peter Fraser

What will the nominee's age be on 26 January 2027? *Note: The age of the nominee must fall into the applicable category as of 26 January of the ceremony year. Selection of award recipients will take into consideration activities in the year prior to January of the ceremony year, in addition to past and future activities. If you do not know the Award Nominee’s age please provide an estimated age range. If you are nominating a group for the Community Group Award, please type 'not applicable’ as the answer.

Is the person you are nominating an Australian citizen? *

YesNoUnsure

Nominee's full name or group/organisation/business name *

Nominee's email address *

Nominee’s address (Street number, Street name, Suburb/Town, State/Province, and Postcode are required. Include Parent or guardian’s address if nominee is under 18 years of age). *

Nominee’s mobile phone number *

Nominee’s alternative phone number (optional)

What is the nominee's preferred communication method? Please tick all that apply *

EmailPhone

Information To Support Your Nomination

When completing your nomination, please ensure you include as much information as you can about the person or group you are nominating. Tell us their story and why they should be the next category recipient.

We’re looking for an individual or a group who goes above and beyond, contributes to their community and inspires those around them.

Provide as much information as you can
You can use dot points
Tell us how your nominee has gone above and beyond
Give examples of the good work they have done
Describe how they have made a difference

Submissions should:

Address the assessment criteria by outlining the nominee’s background, achievements, and reasons for nomination
Include supporting documents such as character reference/s and photograph/s

All eligible nominees will be contacted and provided with the opportunity to accept their nomination and submit further supporting information to be considered as part of the nomination.

Entry details

Please answer the following questions;

Describe the nominees’ activities, explaining how they have positively benefited the community and how they will have a lasting and enduring impact. (weighting 30%) *

Describe the nominee’s outstanding achievement/s giving specific examples or supporting evidence/material and tell us the specific field it relates to (including but not limited to: sports, education, environmental care, community engagement, business, welfare, arts and culture, leadership, civic responsibility, volunteering, acts of kindness and bravery). (weighting 30%) *

Explain why you believe this nominee is a positive role model to others. Provide us with examples or supporting evidence/ materials. (weighting 20%)

Confirm whether the nominee is located within the Liverpool Local Government Area (LGA) and tell us how this nominee is delivering a service to the Liverpool community. (weighting 10%) *

Attachments (optional)

Note: Attachments are not mandatory, but can help to support your nomination. You may upload documents such as character, copies of certificates, awards, photos, newspaper clippings or other relevant documents (optional).

You may attach a maximum of two pages

Attach documents or other records to support your nominee’s service or achievements if you have them.

Browse

Nominator's Contact Information (your details)

Nominator's full name *

Nominator’s address (Street number, Street name, Suburb/Town, State/Province, and Postcode are required). *

Nominator’s mobile phone number *

Nominator’s alternative phone number *

Nominator’s email address *

I would like to keep my nomination anonymous - This means the person or group you have nominated will not be advised that you have nominated them *

NoYes

Referee details (optional)

Referee’s full name

Nominator’s email address

Nominator’s mobile phone number

Nominator’s alternative phone number

What is the Referee’s preferred communication method? Please tick all that apply.

EmailPhone

Declaration

I have read and accept the Eligibility Criteria, Conditions of Entry and Assessment Criteria *

The information contained in this nomination is, to my knowledge, true and accurate. *

I agree to the information provided by me to be forwarded to the Liverpool Awards Judging Panel, and to be published in Liverpool City Council media, communications and publications. *

I understand that the individual that I am nominating will be contacted to obtain further information. *

Signature *

Draw signature|Type signatureClear

Date

How did you hear about the Australia Day Award? Please tick all that apply

Other

Was there a specific reason or event that prompted you to nominate (for example, you learning you could nominate, a milestone in the nominee’s life or career)?