Nomination Form: The Guilford Young Medal

    Section 1

    Tell us about the person you are nominating for The Guilford Young Medal

    NOTE: Nominations are confidential. Only provide the following details if already known. Under no circumstances should the nominee be contacted for any information.

    Please ensure that all sections marked with an asterisk (*) are completed.

    Place of Birth

    Section 2

    Activities undertaken by the person you are nominating

    In this section, space has been provided for you to set out details of how the nominee has made a significant contribution to the Catholic Church including any positions held/activities undertaken, together with relevant dates of service. Also, please include a statement in your own words about why you think the person should be recognised.

    As a guide, you may wish to consider some of the following questions:

    • In what role(s) or area(s) has the nominee excelled?
    • How has the nominee demonstrated service to the Church worthy of recognition?
    • How has the nominee’s contribution impacted on a particular ministry, apostolic work, parish, agency, community or the Church at large?
    • Over what period of time has the nominee made a major contribution?
    • Has the nominee’s contribution been recognised elsewhere (e.g. in the media, by other awards, professional/interest groups)?
    • What makes this person stand out from others?

    Section 3

    Details of referees who are able to make direct comment on the contribution/service of the person you are nominating

    Referee 1

    Referee 2

    Referee 3

    Referee 4

    Section 4

    Details of person submitting nomination

    Please provide your contact details to enable officers of the Archdiocese of Hobart Honours & Awards Secretariat to seek further details, if required.

    Checking this box forms your signature and confirms that all information provided on this form is accurate and true to the best of your knowledge.

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