Please complete the relevant sections of the below form, click submit and wait for the confirmation page to display. If you experience any difficulties with the form, please contact our friendly Customer Service team on 4099 9444 or email enquiries@douglas.qld.gov.au

Nominations close Friday 19 November 2021.

  • Details of Nominator (you)

  • Details of Nominee

  • Details of Parent or Caregiver

    (Only applicable if the nominee is under 18 years of age)
  • Record of Achievements

    Please answer the below questions addressing the nominee's relevant contributions.
  • Please keep in mind that your response may be published or read out during the ceremony. (200 words or less)
  • Referee Details