NOMINATION FORM

VICTORIAN MANUFACTURING HALL OF FAME

COMPANY INDUCTION

(All business sizes)

This award recognises excellence in manufacturing for a Victorian based organisation.

Nominations must be filled out in full and submitted to the Victorian Manufacturing Hall of Fame Secretariat by Monday, 23 February 2015. Only typed entries will be accepted).

NOMINEE
Organisation
ABN
Address
Head Office Address
Contact Person
Title
Email Address
Telephone (landline)
Telephone (mobile)
Web Address
Company Background (please provide a 100 word profile of the company)
(** Do not include any confidential information in this section, as it may be used in preparation of press releases and collateral)
List Australian & International Quality Standards / Accreditation
Products Manufactured interstate and/or offshore (if any)

List Australian & International Quality Standards/Accreditation

Products Manufactured/Services Provided(must be Victorian based)

Operationsinterstate and/or offshore(if any)

Employees/projected Growth in Number of Employees:

Is this company listed on the Australian Stock Exchange?

Parent Company(if any)

Subsidiaries(if any)

Alignment with priority growth sectors

Medical technology and pharmaceuticals

New energy technology

Food and fibre processing

Transport, defence and construction technologies

Professional services (eg design or engineering)

International education services for the manufacturing sector.

Export Record(include value of exports, list products/services exported & countries exported to)

Advanced manufacturing (integration of new innovative technologies in both products and processes. Suitable examples include the rate of technology adoption and the ability to use that technology to remain competitive and add value and the rapid transfer of science and technology into manufacturing products and processes)

Lean Manufacturing Practices

Environmental Management Initiatives(eg reduce, reuse)

Financial Assistance received

(if applicable, please detail grant type, amount and date)

Awards Received(not mandatory)

1 / Award Name
Awarded by
On(presentation date)
2. / Award Name
Awarded by
On (presentation date)
3. / Award Name
Awarded by
On (presentation date)
4. / Other

Images to be provided by nominee

  1. Submit with your application 5x high resolution photographs of the nominated organisation (e.g. staff, manufacturing processes, building front, products etc).
  2. Submit your logo with your application (eps format)

DECLARATION BY NOMINATOR

The nominating entity, as a condition of recommending the above company, confirms it has satisfied itself that neither the company nor its subsidiaries have been convicted of breach of WorkCover, Trade Practices Act, Environmental Protection Act, Equal Opportunity Act or other State or Federal laws within the previous 12 months or if convicted have not had imposed on any of them a penalty of more than $10,000 for any such breach.

The nominating entity has satisfied itself that the nominated company and its subsidiaries has a strong financial record.

I hereby declare that the information provided in this nomination is correct at the time of submission and that the company I have nominated is located in Victoria, Australia and is an established manufacturing plant or provides educational or professional services to Victorian manufacturers.

Signature
Name in full
Title
Organisation
Mobile Telephone Number
Email address
Date

Please attach logos and images with the completed nomination form and any supporting information and email or mail full submission to Alison O’Keefe, Industry Programs Branch, Department of Economic Development, Jobs, Transport and Resources, GPO Box 4509RR, Melbourne Victoria 3001or by email to Victorian Manufacturing Hall of Fame Secretariatby the close of business, Monday, 23 February, 2015.

The Victorian Manufacturing Hall of Fame has been established to publicly acknowledge excellence in Victorian manufacturing and to promote this excellence to a global industrial market and the general public.

The Victorian Manufacturing Hall of Fame has been established to publicly acknowledge excellence in Victorian manufacturing and to promote this excellence to a global industrial market and the general public.

CONDITIONS

  1. All companies nominated for Victorian Manufacturing Hall of Fame recognition must have a manufacturing plant located in Victoria and/or demonstrate specialist services directly connected to Victoria's manufacturing industry.
  2. Nominations for Induction into the Victorian Manufacturing Hall of Fame will only be accepted from -
  • incorporated Australian industry associations or
  • companies that wish to nominate themselves (however they will be required to provide a reference from another entity such as a major client, industry association or union and they must make the declaration required on the front of this form)
  • other industry entities approved by the Minister.
  1. Manufacturers who have won industry association or other recognised awards but whose goods are produced entirely in other Australian states or internationally are ineligible for recognition in the Victorian Manufacturing Hall of Fame.
  2. The industry association award or other recognised award can relate to any facet of a manufacturing operation that has been rewarded for excellence for example - marketing, work safety, international supplier awards.
  3. Change of ownership of an inducted manufacturing corporation will not necessarily jeopardise the Hall of Fame standing of that organisation providing the core manufacturing line does not alter.
  4. Any manufacturer inducted into the Victorian Manufacturing Hall of Fame who is, after induction, convicted of any criminal offence or legislative breach where the penalty imposed is greater than $10,000 will be asked to show cause as to why it should not have its induction revoked, be required to remove any display of the Hall of Fame symbol in all materials and cease indicating that it has any Hall of Fame or Victorian Government recognition. The Minister will then decide in her absolute discretion whether the manufacturer will have its induction revoked.
  5. In addition, inductees who cease manufacturing in Victoria or move their manufacturing operations to another state or off-shore will have their induction revoked and will be required to remove any display of the Hall of Fame symbol in all material and may not indicate that it has any Hall of Fame or Victorian Government recognition.
  6. The Minister’s decision on eligibility for the manufacturers being nominated, the entities nominating them or the provision or revocation of an award certificate, induction or other recognition is final and no correspondence will be entered into.
  7. An industry panel will be appointed to review the nominations.
  8. The industry panel reserves the right to refer the nomination to another category.
  9. A weighted criteria will apply across export record, quality management, lean manufacturing, history of strong growth, contribution to Victorian manufacturing, sustainability initiatives, employee satisfaction, compliance with legislative requirements etc.
  10. The awards will be announced at a ceremony to be held on Tuesday, May 26 2015 at the Palladium Ballroom, Crown Entertainment Centre.

Page 1