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ADULT RECOGNITION AWARDS NOMINATION FORM

Use this form to nominate a Uniformed Leader or Other Adult Member Supporter for Silver Wattle, Outstanding Service, Silver Koala, Distinguished Service, Silver Emu, National President’s or Silver Kangaroo Award.

1. Complete the relevant sections with the evidence to support the nomination, and

2. Attach the Nominee’s Extranet record to this form.

Nominee personal details:

Title *

First Name *

Last Name *

Postnominals

Current Address *

Appointment *

Formation *

Child Safe Scouting Completed (Scouting Preliminary : Members only) *

Completed
Not applicable

Date completed / Exempted (if not applicable please write N/A) *

WHS For Scouting Completed (Scouting Preliminary : Members only) *

Completed
Not applicable

Date completed / Exempted (if not application please write N/A) *

An Adult Member nominated for an Award of Silver Wattle and above, is required to have completed a Wood Badge and if not relevant to their current role, then Leadership (Formerly referred to as Advanced Training) training aligned to their appointment.

An Adult Member who has recently changed roles (i.e., within the last 12 months) may be nominated for an award of the Silver Wattle and above without completing Leadership training aligned to their current appointment, provided they hold a Wood badge and Leadership training relevant to their immediate previous role.

Wood Badge Held(Leader Proficiency : Leaders only) *

Completed
Not applicable

Date Completed (if not application please write N/A) *

EVIDENCE OF SERVICE TO SUPPORT RECOMMENDATION

Write at least 2 sentences of evidence for each of the following six criteria, supporting why the Nominee’s service is worthy of recognition. List dates, events and places as appropriate and only refer to service and evidence since the Nominee’s most recent award (if applicable). Evidence can be typed directly in the space provided, or if formatted in a similar manner, attached as separate page/s.

AWARDS

*Not applicable for Other Member or Supporter.

Most recent/last Adult Recognition Award

Year Awarded

AWARD nominated for this year

How has the nominee carried out the responsibilities of their current Certificate of Proficiency (Formerly referred to as a Certificate of Adult Leadership) , non- uniformed management/supporting role, or Young Adult (Rover Scout) Membership to the highest standard and how has this contributed to youth membership growth or the wellbeing of Scouting? *

How has the nominee demonstrated that they are a team player? How has this benefited Scouting? Have they demonstrated a commitment to mentoring other Adults in Scouting? *

How has the nominee demonstrated leadership which has inspired enthusiasm among other Adults in Scouting? *

What ideas has the nominee provided for the future direction of Scouting and how effectively have these ideas been implemented to benefit the development of youth and/or adults? *

Especially for higher awards - how has the nominee contributed to the wider Scouting forums (including internationally) and formations by involvement in activities beyond the level of responsibilities normally expected in the appointment or management/supporting role held? *

In addition to the five award criteria above, has the nominee contributed significantly to the community generally, other than through Scouting? If so, please provide details *

CITATION SUMMARY

In at least two-three brief paragraphs, please give a summary of the six criteria above to clearly articulate why this award is recommended. This should be written in the third person so that it could be read out in support of the recommendation when the award is presented. *

MEDIA RELEASE

Please list any local media outlets for distributing media releases. *

Please attach Nominee's Extranet membership record here. *

List of Allowed file types

RECOMMENDATIONS AND ENDORSEMENTS

Nominator's Role *

Optional: please provide an email address if you would like a copy of your submission sent to you.

I hereby nominate the above nominee

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ADULT RECOGNITION AWARDS NOMINATION FORM

Approvals

Human Endeavour Recognition Committee Notification

2024 Nomination endorsed by

Branch office review