Nomination Form - Honorary Life Membership

Recognises exemplary and outstanding service in any capacity.

Nominations for this Award can be made at anytime.

Advice to APF State Committees: State Committees should not discuss nominations in open meetings.

Please use the form below to nominate your desired candidate and describe below the nominee’s outstanding service and include examples that best show their achievement and contribution to the APF and/or Parachuting in Australia.

Honorary Life Membership Nomination Form

Nominee's Details

Nominee's Name*

Nominee's APF Number (If Known)

Nominator's Details

Nominator's Name*

Nominator's Email Address*

Nominator's Best Contact Number*

Nominator's Secondary Contact Number

Referrences

Name of Reference #1*

Reference #1 Email Address*

Reference #1 Best Contact Number*

Name of Reference #2*

Reference #2 Email Address*

Reference #2 Best Contact Number*

Name of Reference #3

Reference #3 Email Address

Reference #3 Best Contact Number

Details for the Nomination

Synopsis*

In what role(s) or area(s) has the nominee excelled?*

How has the nominee demonstrated service worthy of recognition?*

How has the nominee’s contribution impacted on either a particular field, of parachuting, or locality, group, or the sport at large?*

Over what period of time has the nominee made a major commitment?*

Has the nominee’s contribution been recognised elsewhere (e.g. in the media, by other awards, local clubs or an Area Committee)?*

Submission Details

Date of Submission*

Mandatory field(s) marked with *

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2994 Logan Road, Underwood
Queensland 4119, Australia

Phone: +61 7 3457 0100
(International: +61 7 3457 0100)

Postal Address:
Po Box 1440, Springwood
Queensland 4127, Australia

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