Vinnies Social Justice Awards Patron: Monsignor David Cappo AO, Commissioner for Social Inclusion
2009 NOMINATION FORM - WEB COPY Please FAX to Tim Taylor, 8112 8798 or post to GPO Box 1804, Adelaide. 5001
THIS FORM IS TO BE USED BY THOSE WHO HAVE ALREADY BEEN NOMINATED AND ACCEPTED BUT HAVE NOT COMPLETED THIS FORM IN FULL. YOU SHOULD ALREADY HAVE RECEIVED YOUR INVITATION Name of Nominee: ___________________________ Current Age: ____ Nominating Body (School) ______________________ Current Year Level _____ Please tick the award you have been nominated for(Tick one box only)
Primary Years: (Yrs 3-5): Joseph Emmanuel Bailly Award Middle Years (Yrs 6-9): Rosalie Rendu Award
Senior Years: (Yrs 10-13) Blessed Frederic Ozanam Award Young Adult: (recent school leaver) St Louise de Marillac Award
Your nominating Teacher ______________________________
ACCEPTANCE OF NOMINATION To be completed by the nominee (and parent if under 18) I (insert name) __________________________________ accept the nomination for the above award. I understand that I will be invited to attend the awards ceremony on evening of Tuesday 1st September at Nazareth College (Flinders Pk) and will be invited to bring two guests. Acceptance of the nomination is dependant on the following: ∗ The nominee agrees that they have done the Good Works as outlined above. ∗ The nominee agrees to create one PowerPoint slide (no animations) with their name and a photo (if desired) which gives the audience a sample of their Good Works. (The school may help you with this.) Audio / Visual Permission (Please tick box as desired) I give permission for all images and audio-visual data (DVD, Video, photos etc), taken as part of the evening, including those in the PowerPoint presentation, to be available for the St Vincent de Paul Society to use in printed materials, educational presentations, online media, including the Society’s websites. The St Vincent de Paul Society commits itself
to use all audiovisual material in a way that shows discretion, upholds the dignity of the individual and enhances the Society’s image. Or
I do not give permission (If you do not give permission, you will not have access to photographs of yourself online.)
Signature of Nominee ____________________________ Date: _____________
Signature of Parent / guardian (if nominee under 18). ________________________ Date: _______________