Order of Liverpool Awards 2023 Nomination Form

Before submitting a nomination form please read the Liverpool City Council Order of Liverpool 2023 Guidelines.

Nomination forms and associated information must be received by Friday 30 June 2023.

Completed nomination forms can also be sent to:

Council and Executive Services
Locked Bag 7064
Liverpool BC NSW 1871
or emailed to awards@liverpool.nsw.gov.au

Person Being Nominated

NOTE: Nominators are asked to check with the person that they are nominating that they would be willing to accept an award if nominated.

Applicants may include up to two copies of any other relevant information (such as certificates, awards, photos, newspaper clippings, etc.).

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Details of person submitting nomination

Details of Referee