Nomination Form
Community Engagement
Awarded in recognition of outstanding contribution to improving understanding and connection with coastal and marine environments through engagement with the wider community.
Submissions in this category may include:
- on-ground works (e.g. protection, conservation, revegetation, rehabilitation)
- programs and projects
- planning (e.g. foreshore management plan)
- schemes/strategy (e.g. biodiversity strategy, conservation strategy)
- monitoring/surveying
Nominations are encouraged from community groups, schools, universities, Coastcare groups, ‘friends of’ groups, Committees of Management (CoMs), private companies, Traditional Owners, partnerships, not-for-profit organisations, and local and state government departments and agencies.
Previous Winners
2014Joint award winners
Marine Volunteer Network
Awarded for the Sharing the Love Program
Nelson Coastcare Group
Awarded to the Ecoliteracy advocates and Ramsar-worthy Group
2013Joint award winners
Dolphin Research Institute and Kingston City Council
Awarded for the “i sea, i care” Program
Disabled Surfers Association - Ocean Grove Branch
Awarded for the Putting Smiles on Dials Program
Nomination Details
Project TitleName of group or organisation
Street Address
City or Town / Postcode
Contact person
Position
Mobile contact number
Email address
Website (if applicable)
Social media (if applicable)
Nominator Details
Title (please circle) / Mr Ms Miss Mrs DrName of nominator
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position(if applicable)
Organisation
Please complete this section if the group’s work was developed or implemented in partnership with another organisation or individual.
Partner OneTitle (please circle) / Mr Ms Miss Mrs Dr
Name
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position (if applicable)
Organisation
Briefly outline the nature of the partnership as it relates to the nomination
Partner Two
Title (please circle) / Mr Ms Miss Mrs DrName
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position (if applicable)
Organisation
Briefly outline the nature of the partnership as it relates to the nomination
Nomination Summary
Please provide in 250 words or less a summary of the nomination. Please note that this summary may be used in promotional material for the awards, including media releases and on the VCC website. The summary should reflect the intrinsic nature of the award entry.Previous Award Declaration
Has the nomination previously received an award? / Yes / NoName of Award
Presented by
Date received
Key Selection Criteria
- Response to each question must be less than half a page
- Point form is encouraged
- How has the group contributed to improving the wider community’s understanding of, and connection with, coastal and marine environments? Include outcomes to date and anticipated longer-term outcomes.
- Provide details of how the group has engaged with the community and how partnerships were built and maintained with key stakeholders to achieve greater understanding and connection with coastal and marine environments.
- How does the group’s work align with the objectives of local, regional or state programs, strategies or policies? Your answer should include the name of the relevant documentation.
- How has the group developed the community’s skills, understanding and connection with the coastal and marine environment. Your answer should include details of how many people the program/initiative has reached.
- How has the group demonstrated leadership within the wider community?
Please provide two referees this may include yourself as the nominator but may not include the nominee. One referee must be independent of the project being nominated.
Referee One
Title (please circle) / Mr Ms Miss Mrs DrName
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position (if applicable)
Organisation
Referee Two
Title (please circle) / Mr Ms Miss Mrs DrName
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position (if applicable)
Organisation
Award Recipient
Provide the name and contact details of the person(s) who will accept the award on presentation night if successful.
Title (please circle) / Mr Ms Miss Mrs DrName
Street Address
City or Town / Postcode
Phone number
Mobile phone number
Email address
Position (if applicable)
Organisation
Images and supporting material
Images and supporting material that demonstrate the success of the nomination are highly encouraged. The submission, including attachments may not exceed 5MB and may only include 5 images.
If there is a requirement to provide large attachments or high resolution photographs, please supply these via post on a USB to:
Victorian Coastal Awards for Excellence 2015
Victorian Coastal Council
PO Box 500
East Melbourne Victoria 8002
Correspondence from the Victorian Coastal Council
All correspondence from the Victorian Coastal Councilshould be addressed to
(please mark the box with an ‘X’):
Contact details for nominator
Contact details for nominee
Both of the above
Terms and Conditions
By marking this box an ‘X’ I indicate that I have read and agree with the Victorian Coastal Awards for Excellence Terms and Conditions of entry and the Privacy Statement, found on the Victorian Coastal Council website.
NameSignature
Date
Victorian Coastal Awards for Excellence 2015
Nomination Form – Community Engagement
Page 1 of 9