Consumer Achievement Award 2019 - Council to Homeless Persons

The 2019 Victorian Homelessness Achievement Awards will celebrate the exceptional efforts of specialist homelessness services, consumers and other community members to end homelessness in Victoria.

About the Consumer Achievement Award

This award will recognise an individual who has experienced homelessness and has made an outstanding contribution to improve the lives of others experiencing homelessness in Victoria.

Instructions and timeline

If you would like to nominate a consumer for the award, please complete the form below.

The activity or activities for which the nominee is being recommended must have taken place at some point between 1 January 2017 and 31 June 2019. Activities that commenced, were in progress, or were completed over this period are all eligible.

Please note that the nominee is entitled to a copy of this application.

In order to be eligible for consideration, nomination forms must complete all fields and be received by 5 pm, Sunday 25 August 2019.

This application form may be saved and returned to at a later date.

Judging and award presentations

A panel of consumer, sector, research, and government representatives will assess the nominations. The awards will be presented at the Victorian Homelessness Conference 2019 on Monday 14 October 2019.

The word limit in each field is provided as a maximum guide. Nominators should not feel obliged to write lengthy responses.

If you would like more information about the awards or assistance in completing the nomination form, please contact Damien Patterson, Policy and Advocacy Officer, on 03 8415 6209 or via email at damien@chp.org.au

Your details

This section is about you, the nominator. We will ask about the nominee further down the page.

Name*

First Last

Organisation

Position

Address*

Telephone*

Email*

Nominee's details

Please provide the nominee's contact details

Name*

First Last

Address*

In case we need to post anything

Telephone*

Email*

Has the nominee been formally recognised through any other awards or commendations?*

No.
I'm unsure
Yes

What other awards or commendations have recognised the nominee?*

Experience of homelessness

This answer will only be used to determine eligibility for this award, and will not influence the judges deliberations.

In no more than 600 characters (about 100 words), please provide a brief description of the nominee's experience of homelessness.*

This answer will only be used to determine eligibility for this award, and will not influence the judges deliberations.

About the nominee

In no more than 900 characters (about 150 words), please describe the activity or activities for which this person is being nominated.*

Community education

In no more than 1200 characters (about 200 words), please describe how the nominee has contributed to educating the community about the lived experience of homelessness (eg. sharing their story, art projects, media engagement). Please provide examples and describe where and when these activities took place and who they were targeted towards.*

Advocacy to Government

In no more than 1200 characters (about 200 words), please describe how the nominee has advocated for improved government responses for those who are experiencing homelessness (eg. sitting on government advisory groups, campaigning for policy change, participating in government consultations, contributing to or preparing submissions). Please provide examples and describe where and when these activities took place and who they were targeted towards.*

Improving service responses

In no more than 1200 characters (about 200 words), please describe how the nominee has contributed to improving service responses for those who are experiencing homelessness (eg. advising programs or agencies, participating in research projects, campaigning for practice reform, providing support and advice to others experiencing homelessness). Please provide examples and describe where and when these activities took place and who they were targeted towards.*

Reference details

Please provide details of two references who can be contacted about this nomination. Both references must be from outside of the nominee's organisation.

Please discuss the application with both references prior to providing their details.

I have discussed this application with both references and they have agreed to provide a reference.*

Yes

Reference one

Name*

First Last

Organisation*

Position*

Telephone*

Email*

Reference two

Name*

First Last

Organisation*

Position*

Telephone*

Email*

Declarations

Please ensure that both you and the nominee have read and understood the relevant declarations below.

You may check the declaration on the nominee's behalf if you have read the declaration to them and they have agreed.

Nominee or key contact person's declaration

I agree to be nominated for a 2019 Victorian homelessness achievement award. I agree that Council to Homeless Persons or its agents may use the information provided in this form to assess nominations for the awards and for publicity purposes associated with the awards. I consent to Council to Homeless Persons or its agents contacting the people named in this form and seeking comment from them regarding this nomination. I acknowledge that Council to Homeless Persons will store this information securely.

*

The nominee has read and understood this declaration

Your declaration

By submitting this nomination for the Victorian homelessness achievement awards I certify that all information provided is true and correct to the best of my knowledge. I agree that Council to Homeless Persons or its agents may use the information provided in this form to assess nominations for the awards and for publicity purposes associated with the awards. I consent to Council to Homeless Persons or its agents contacting the people named in this form and seeking comment from them regarding this nomination. I acknowledge that Council to Homeless Persons will store this information securely.

*

I have read and understood this declaration