You must have JavaScript enabled to use this form. The Lord Mayoral Awards honour people with disabilities who have made a significant impact in the community by standing up for the rights and well-being of others with disabilities. You can submit multiple nominations, nominate yourself, or nominate someone else. The person you nominate must live in the City of Darwin. Your contact details (person making the nomination) Name Phone Email Please provide details of the person you are nominating Name Phone Email Nomination Category (please select a category for your nomination) The Champion Award A person who has made an outstanding contribution to the community advocating for the rights and well-being of people with disability The Rising Star Award A person under 25 who makes an ongoing contribution to their school, workplace or community advocating for the rights and well-being of people with disability Accessibility Innovator Award Open to individuals or teams (with or without disability) who have developed an innovative, impactful solution improving accessibility for people with disability Community Impact Award Recognises individuals or groups (with or without disability) whose efforts through activism, advocacy, volunteering, or community programs have advanced everyday inclusion for people with disability. Please describe how the nominee meets the criteria of the selected award category Please attach any supporting evidence if required. One file only.30 MB limit.Allowed types: gif, jpg, jpeg, png, txt, rtf, html, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg. Privacy Statement Information provided in this form will be used for the assessment process and award announcements. The person nominating may be contacted to clarify any information contained within the form. City of Darwin may disclose the information provided by you to a third party in accordance with the NT Information Act or our Privacy Policy which is available on our website. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
