Nomination Form

St Michael’s Grammar School is renowned for our exceptional wellbeing and academic programs and our commitment to innovative and holistic approaches to teaching, learning and caring. We empower our students to approach their lifelong learning journey with courage, confidence and a strong sense of social justice so that they leave us with the skills, knowledge and character to be contributing citizens of the world.

Our graduates leave with the determination to follow their passions, the confidence to lead and the wisdom to live balanced and meaningful lives inspired by a commitment to making the world a better place.

The Old Michaelian Contributing Citizen Awards aim to recognise significant contributions made by past students to the local, national and global community.

St Michael’s Grammar School is seeking nominees for these awards in the following three categories:

Old Michaelian Contributing Citizen Award
Old Michaelian Contributing Citizen Young Achiever Award (for Old Michaelians under 35 years old)
Old Michaelian Contributing Citizen Legacy Award (awarded posthumously)

To nominate an Old Michaelian please complete the following form. It is important that you complete all details.

For further information or if you have questions about the nomination process please contact:

Gloria Cafra – Engagement Marketing Manager

Email: engagement@stmichaels.vic.edu.au

Phone: +61 3 8530 3298

Nominations must be submitted by 11.59pm on Tuesday 20 August 2024

Using this nomination form

This form must be completed and submitted in one session. You cannot Save and return to the form later; your information will be lost.
It is recommended that you type your written responses in a separate document and use the copy/paste function to enter text into the form fields.

"*" indicates required fields

NOMINEE DETAILS

Name*

Name at School (if different from current name)*

Years attended St Michael’s Grammar School*

Phone (Preferably mobile). Leave blank if unsure.

Email. Leave blank if unsure.

NOMINATORS' DETAILS

Primary Nominator (this person will be the main contact for queries about this nomination)

Name*

Relationship to nominee*

Connection to St Michael’s Grammar School:*

Phone (Preferably mobile)*

Email*

Second Nominator

Name

Relationship to nominee

Connection to St Michael’s Grammar School:

Phone (Preferably mobile)

Response to criteria

Please outline the nominee's demonstration of each of the selection criteria outlined:

1. Positive impact on, and contribution to, the local, state, national or international community and/or the St Michael’s Grammar School community above and beyond employment duties or formal responsibilities. (Max 3000 characters)*

2. Positive impact in one or more of the following: Leadership, Volunteerism, Innovation, Sustainability, Advocacy, Social Change or Education. (Max 3000 characters)*

3. Adherence to high ethical standards, integrity, transparency and the St Michael’s values of Dignity, Respect, Care and Compassion. (Max 1500 characters)*

Support Documents

These may be further evidenced by documented project or program outcomes, accolades, awards or honours, or by endorsements of support and testimonials from community members or organisations. Please upload file/s as applicable evidence here. File number limit is 5, and single file size limit is 10MB. Allowed file types are: Word, Excel, PPT, PDF and Image files. Please note Video files will not be accepted.

Nominations must be submitted by 11.59pm on Tuesday 20 August 2024

File

Drop files here or

Accepted file types: doc, docx, xls, xlsx, ppt, pptx, pdf, jpg, jpeg, png, Max. file size: 10 MB, Max. files: 5.

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