Award of National Trust Honours Form

Name of Nominee(Required)

First Last

Address(Required)

Street Address Suburb State Post Code Country

Email(Required)

Phone(Required)

Membership Number

Name of Nominator(Required)

First Last

Office of Nominator(Required)

(Eg Chair, Blue Mountains Branch)

Address(Required)

Street Address Suburb State Post Code Country

Phone(Required)

Membership Number(Required)

Citation(Required)

Trust Commendation – 5+ years service (In exceptional circumstances an Award may be granted for a shorter period of service.)

Voluntary Service Award – 10+ years service

Meritorious Service Award – 15+ years service

Honorary Life Membership - only Trust Members

Years of Service(Required)

Please enter a number from 1 to 100.

Positions Held & Where(Required)

example Chair of Branch, Committee etc

Leadership

Areas of excellence that enrich the Trust

Team work and support for others

Reliability

Organisational Skills

Commitment to the Vision and Mission of the Trust

Other relevant information

Nomination Form for the Award of National Trust Honours