• NOMINEE DETAILS

    (the person you would like to nominate)
  • NOMINATOR DETAILS

    (your details)
  • Charity of Choice

  • Questions

    Please fill out the questions below.
  • Images

    Please upload a minimum of 5 high resolution images of the nominee.
  • Max. file size: 10 MB.
  • Max. file size: 10 MB.
  • Max. file size: 10 MB.
  • Max. file size: 10 MB.
  • Max. file size: 10 MB.
  • By completing and submitting this nomination form you confirm:
    • Prior consent has been obtained from the person/persons/organisation nominated;
    • Permission to publish, if successful;
    • The philanthropic endeavours of the nominee benefit non-profit organisations in the state of Queensland;
    • Information provided will be shared with our judging panel, sponsors, and the public via publications and through media outlets for publication and distribution via newspapers, radio and television.