Your supporting statement should be a minimum of 200 words and a maximum of 500 words.

You can write your statement in Word so you can easily track word count and paste the text back into the submission form.

Please provide the following information in your statement: 

  1. Please tell us a little bit about your nominee – what support do they provide to you, or others, how long have you known or worked with them, and any other relevant background information
  2. Please provide some examples of what makes them stand out from the crowd – what have they done that’s made a difference to you or someone else?
  3. What impact have their contributions had – for example your own personal thoughts about how they've helped you, or a quote/story about how they’ve helped someone else.
  4. Please consider how your nominee demonstrates: 
  • Our values - kindness, fairness, ingenuity, determination
  • Our ambitions – outstanding care, great place to work and listen to improve

Please only use one of the following options for each submission. Duplicate submission forms can sometimes cause confusion and extra admin work. 

Nominate your community choice by electronic form (MS Forms)

Nominate your community choice using a paper form (Word) - to add

Nominate your community choice using a paper form (PDF) - to add