Online Form - Volunteer Nomination Form

2024 Certificate of Appreciation Submission Form

To recognise the valuable contribution of longstanding volunteers within community organisations,
the Shire of Murray will award a Certificate of Appreciation to volunteers who have reached a 5 year, 10
year or 20-year milestone. Submissions are also encouraged for Outstanding Contributions by a
Volunteer. Certificates of Appreciation will be presented at the 2024 Volunteer VIP Function on May 21.

Certificates of Appreciation:

• Recognition of 5 years’ volunteer service to community
• Recognition of 10 years’ volunteer service to community
• Recognition of 20 years’ volunteer service to community
• Recognition of Outstanding Contribution

Submissions close Sunday, 19 May 2024.

Conditions of Entry

• Nominees should actively volunteer in the Shire of Murray

Select a Category

The Nominee has completed (please check box)*

5 Years' of volunteer service to community10 years' of volunteer service to community20 years' of volunteer service to community
Outstanding Contribution

Volunteer Details (person being nominated)

Name:*

Address:

Street Address:*

City:*

State:*

Post Code:*

Country:*

Telephone:*

Email:*

Nominator Details (Group or Club making the nomination)

Group or Club

Position Held:

Name:*

Telephone:*

Email:*

Will you be attending the Volunteer VIP Function*

YesNo

If yes, please register your attendance here

Volunteer Contributions

Please list volunteer organisation/s where community service has been undertaken:*

What year did the nominee commence volunteering in the Shire of Murray:*

Details of outstanding contribution by volunteer (if applicable):*