Commemorative Mission to Borneo
70th Anniversary of the Operation Oboe Landings
(Tarakan, Brunei & Labuan, andBalikpapan)
VETERAN NOMINATION FORM
(Please refer to the information on Page 4 of this form)
Nominator’s Details
(Nominator to complete)
(Note: veterans can self-nominate if they wish)
Title: / Full Name: / Post Nominals:
Organisation:
______
______
______ / Postal Address:
______
______
State______P/Code______ / Daytime Telephone:
( )______
Other Telephone:
( )______
Email:
______
Veteran Being Nominated
(Nominator to complete)
Title: / Full Name: / Post Nominals:
Reasons for Nomination
(Nominator to complete)
Attach a separate sheet if required.
……………………………………………………………………………………………
Signature of Nominator / ______/______/20______
Date
Nominee’s Details
(All Nominees to Complete)
Title: / Full Name (as it appears on your passport or birth certificate): / Post Nominals:
Preferred First Name: / Date of Birth:
_____/_____/19______
Residential Address:
______
______
______
State______P/Code______ / Postal Address (if different):
______
______
______
State______P/Code______ / Daytime Telephone:
( )______
Other Telephone:
( )______
Email:
______
Do you have an Australian Passport?
Yes No Passport No: ______Expiry Date:___/___/20___ / DVA File No:
______
Emergency Contact #1
Name:______
Address: ______
______
Phone Number: ______ / Emergency Contact #2
Name:______
Address: ______
______
Phone Number: ______
Second World War Service
(All Nominees to Complete)
Date and place enlisted
Service / Navy Army Air Force
Service No
Discharge date
Rank on discharge
Decorations
Outline of Service During Second World War
(All Nominees to Complete - Provide as much detail as possible)
Which ship, unit or squadron (with dates) did you serve with during the War?
Where did you serve during the War?
What was your role?
(eg: seaman, gunnery, infantry, artillery, signals, medical, air crew etc.)
Do you have an interesting story or anecdote about your service during the Second World War (particularly about your service on the Oboe Landings)?
Attach a separate sheet if required.
What struck you most about your fellow servicemen and women during your service?
Attach a separate sheet if required.
Do you have any special stories of mateship during your service?
Attach a separate sheet if required.
Outline of Post-War Experiences and other military service
(All Nominees to Complete – Provide as much detail as possible)
Attach a separate sheet if required.
……………………………………………………………………………………………
Signature of Nominee / ______/______/ 20_____
Date
Important Information for Nominees
The information you provide on this form is required by the Department of Veterans’ Affairs to assist in the selection of Australian veterans of the Second World War to participate in an Australian Government commemorative mission to Borneo. The purpose of the Mission is to participate in ceremonies and activities that will commemorate the 70th anniversary of the Operation Oboe landings on Borneo at Tarakan, Brunei Bay & Labuan, and Balikpapan. The Mission will take place in early June 2015 and the group is likely be away from Australia for approximately eightto nine days (the exact dates and itinerary are still to be finalised).
Submitting the form
Once completed, this form should be returned no later than 15 December 2014to:
Attention: Mr Stuart Watson
Commemorations Branch
Department of Veterans’ Affairs
GPO Box 9998
CANBERRA ACT 2601
The form can also be faxed to: (02) 6289 4849 marked for the attention ofMr Stuart Watson
If you have any questions, please contactMr Stuart Watsonon: (02) 6289 1109
Nominees must have their General Practitioner or Local Medical Officer complete the enclosed Medical History and Preliminary Assessment form. Completed medical forms should be faxed to DrGraeme Killer AO, Principal Medical Adviser, Department of Veterans’ Affairs, on
(02) 6289 4849. Medical assessments will be treated in the strictest confidence. Please note that further medical assessments will be required for those veterans shortlisted by the Department.
Notes for nominees
- There will be no greater than eight positions available for veterans to participate in the Mission party subject to health and other criteria.
- If you are successful in selection for participation in this commemorative Mission, you will need to be aware of the following:
- the Mission party will travel together as a group from the time of its departure from Australia until its return;
- travel and accommodation arrangements are pre-arranged by the Department of Veterans’ Affairs and you will not be able to be accompanied by a partner or family member. The Department will provide medical and other support staff for the duration of the mission;
- you may be accommodated during the Mission on a twin share basis with another veteran to ensure veterans remain accompanied at all times and as part of a collegiate sharing arrangement; and
- you may be asked to take part in media interviews arranged by the Department, before, during and after the visit. Commemorative visits usually attract considerable media interest and the Department will provide support for these interviews.
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