Cockburn Volunteer Awards Nomination Form

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Before completing this nomination form, please ensure that you have read the Cockburn Volunteers Awards Nomination Guidelines and that you have the nominees permission. Nominations closing date is COB, Monday 2 March 2026.

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Cockburn Volunteer Awards Nomination Form

All fields are required except where indicated.

Nominator Details

Nominator Name (First Name, Last Name):

Nominator Email:

Nominator Phone:

How did you hear about the volunteer awards?:

Nominee Details

Nominee Name (First Name, Last Name):

Nominee Organisation:

Nominee Email:

Nominee Phone:

Nominee Address:

Note: street number and street name are needed for all addresses

Select an award category

Award Categories:

Volunteer Organisation of the Year
Volunteer Organisation award will be presented to a remarkable group, club or not-for-profit organisation who collectively strives to bring positive change to the Cockburn community.

Volunteer of the Year
Volunteer of the Year is an individual volunteer of any age who has made an exceptional contribution throughout the past eighteen (18) months and has created a significant impact in the community.

Mayor's Volunteer Award
The award will be presented to an individual who has volunteered for a minimum of 10 years and has made an outstanding contribution to volunteering in the Cockburn community.

How does the nominee’s volunteering meet the award category?:

NB: Minimum of 100 words / maximum 300 words

Describe the nominee’s role, tasks, activities, responsibilities and achievements:

Give examples of how they go above and beyond.
NB: Minimum of 100 words / maximum 300 words

What impact and benefit has the nominee had on their relevant community:

Provide specific examples.
NB: Minimum of 100 words / maximum 300 words

How long has the nominee been active in the Cockburn community?:

Referee (different from the nominee)

Name (First Name, Last Name):

Phone:

Email:

How does the referee know the nominee:

Terms and Conditions

Read the Terms and Conditions

Checklist

I am over the age of 18

The nominee has been notified of the nomination

The nominee lives or volunteers within the City of Cockburn

I have provided true and correct information

I agree to the above Terms and Conditions

Contact

Telephone: 08 9411 3444
CoSafe: 1300 26 72 33
Email: [email protected]
National relay service: 13 36 77
(ask for 08 9411 3444)
ABN number: 27 471 341 209

Address

City of Cockburn
Whadjuk Boodjar
9 Coleville Crescent,
Spearwood 6163

PO Box 1215, Bibra Lake DC,
Western Australia, 6965

Office opening hours:
8.30am to 4.30pm
Monday to Friday (excluding public holidays)

Language Support

Fire Danger Rating

Social Media

Related links

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Cockburn Volunteer Awards Nomination Form

Find on this page

Cockburn Volunteer Awards Nomination Form

Nominator Details

Nominee Details

Select an award category

Referee (different from the nominee)

Terms and Conditions

Checklist

Related Pages

Contact

Address

Language Support

Fire Danger Rating

Social Media