Fillable Australian Bravery Decorations NOMINATION FORM

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Australian Bravery Decorations NOMINATION FORM

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Country of origin: AUSTRALIA
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The Australian Bravery Decorations are our
own pre-eminent awards for the recognition
of acts of bravery. Since the establishment of
the Australian honours system in 1975 these
awards have recognised acts of bravery by
people whose selfless actions put themselves
in jeopardy to protect the lives or property
of others.
•
Cross of Valour
• Star of Courage
•
Bravery Medal
The group award is known as the Group
Bravery Citation. It shall be awarded for a
collective act of bravery, by a group of
persons in extraordinary circumstances,
that is considered worthy of recognition.
Australian Bravery
Decorations
NOMINATION FORM
•
Commendation for Brave Conduct
Particular features of the Australian
bravery awards are:
Awards may be made posthumously and
presented to the next of kin.
The brave act does not need to occur in
Australia, provided it is considered
worthy of recognition by Australia and in
Australia's interest.
Who can be nominated?
Australian Citizens
A person who is a citizen of another
country and who carries out an act
that may be considered worthy of
recognition by Australia and in
Australia's interest.
Members of Australia's armed forces
who carry out an act in times of peace,
or of war (where the act was carried
out in circumstances other than in
actions against the enemy).
Service personnel from other countries,
whether in Australia or overseas.
What is Bravery?
Brave acts usually involve a deliberate
choice to go from a place of safety to danger
or remain in a perilous situation to provide
help to another. Acts involving the
preservation of life, (for example, first aid)
while admirable, may not be considered
brave.
Confidentiality
All nominations are strictly confidential
and the information provided will be
used only to assist the Council in
considering the merits of the nomination.
The Australian Honours and Awards
Secretariat keeps all nominations
confidential to respect privacy and to
avoid disappointment if an award is not
made. We ask for the cooperation of
nominators and others involved in
respecting this policy.
Who may make a nomination?
Anyone may make a nomination by
completing the nomination form.
Nominations are assessed by the
Australian Bravery Decorations Council,
which is an independent advisory body
consisting of fourteen members including
representatives of each state and territory,
two ex-officio members and four
community members. The Council meets
twice a year to consider all nominations
and make recommendations to the
Governor-General for awards.
How are nominations assessed/decided?
Further information on the Australian Bravery Decorations can be found at www.gg.gov.au
alternatively you can telephone, e-mail or write to the Australian Honours and Awards Secretariat:
Phone (02) 6283 3604 Facsimile (02) 6283 3620 Email honours@gg.gov.au
•
•
•
•
•
•
There are four levels of awards for
individuals, as well as an award to recognise
the bravery of a group of people involved in
a single incident. The awards, commencing
with the highest, are:
Title (Mr, Mrs, Ms,
Dr, Sgt, etc.)
Given Names
Postal Address
Position/Title
Home Phone Number
Business Phone Number
Date of Birth
Place of Birth
(e.g. 0 1 / 11/ 1956)
Surname
Organisation/
Business Name
State
Postcode
Mobile Phone Number
Email Address
1
2016/1
Suburb
State
Postcode
Suburb
State
Country
Town/
Suburb
Description of the incident
Time of incident:
Please provide a brief summary of the rescue efforts elaborating on any elements of risk to the rescuer:
eg. Rescue from flood waters
SECTION
1
Describe conditions: (particularly if unusual or dangerous)
Date of incident:
Location of the incident:
Organisation/ Business
Address
TELL US ABOUT THE PERSON YOU ARE NOMINATING
FOR AN AWARD
In some circumstances a group of persons may have been involved in a single
incident. When nominating multiple people we require the details of each
individual involved. To add additional nominee forms, click this button.
Add Nominee/s
ACTIVITIES UNDERTAKEN BY THE PERSON
YOU ARE NOMINATING FOR AN AWARD
NOTE : If there is insufficient space, you may provide additional information on a separate document and attach them to the
nomination form.
Please set out below details of the actions in which the person you are nominating was involved, and
the reasons why you consider he or she should receive special recognition by the award of an
Australian Bravery Decoration.
If possible, please enclose photographs of the incident or of the place where it occurred. Additionally, you may also supply
media articles and web links that provide further information and details of the incident.
SECTION
2
ACTIVITIES UNDERTAKEN BY THE PERSON
YOU ARE NOMINATING FOR AN AWARD
SECTION
2
CONTINUED
Surname
Surname
Postal Address
Position/Title
Home Phone Number
Business Phone Number
Organisation/
Business Name
State
Postcode
Mobile Phone Number
Email Address
Suburb
State
Postcode
Suburb
Postal Address
Position/Title
Home Phone Number
Business Phone Number
Organisation/
Business Name
State
Postcode
Mobile Phone Number
Email Address
Suburb
State
Postcode
Suburb
NOTE : If there is insufficient space, you may provide additional details on separate sheets and attach them to the nomination
form.
3
SECTION
Involvement in incident:
eg. eyewitness, victim etc.
Involvement in incident:
eg. eyewitness, victim etc.
DETAILS OF PERSONS/EYEWITNESSES WHO ARE ABLE
TO MAKE DIRECT COMMENT ON THE INCIDENT
Please note: While helpful, these details may not always be available.
Title (Mr, Mrs, Ms,
Dr, Sgt, etc.)
Title (Mr, Mrs, Ms,
Dr, Sgt, etc.)
Given Names
Given Names
Organisation/ Business
Address
Organisation/ Business
Address
DETAILS OF PERSON SUBMITTING NOMINATION
Please provide your contact details to enable officers of the Australian Honours and
Awards Secretariat, Government House, Canberra to seek further details, if required.
Organisation/
Business Name
Mobile Phone Number
Email Address
Title (Mr, Mrs,
Ms, Dr, Sgt, etc.)
Given Names
Postal Address
Position/Title
Home Phone Number
Business Phone Number
Surname
State
Postcode
Suburb
More information or help
If you have any further questions, or require guidance in the preparation of the nomination, please call the Australian Honours
and Awards Secretariat, Government House, Canberra on telephone (02) 6283 3604.
Further information can be found at www.gg.gov.au.
SECTION
4
Checking this box forms your signature and confirms that all information provided on this form is accurate and true
to the best of your knowledge.
Declaration
Please note:
If the above link does not work, please send the completed nomination form to bravery@gg.gov.au
Click here to submit nomination
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Completed 21 February 2020

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