Victorian Homelessness Achievement Awards

Consumer Achievement Award

To enter a nomination, please complete the form below.

Consumer Achievement Award 2023

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.

This award will be judged against the following criteria:

Contribution to advocacy for improved government responses to homelessness
Contribution to educating the community about the lived experience of homelessness
Contribution to improving service responses for people experiencing homelessness

This form cannot be saved to complete later. Please consider copying the questions over to a Word document and drafting your answers there. You will then need to submit your answers via this form. Please note that the form will not prevent you from exceeding the word limit for each answer, and it is expected that you will monitor the length of your response.

Nominations close at 9am Monday 9 October. If you would like more information on the awards, please contact Damien Patterson, Policy and Advocacy Officer at damien@chp.org.au

Name of nominator (you)

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Organisation

Position

Postal address for awards related mail

Phone

Name of nominee

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Last

Postal address for awards related mail (if different than above)

Phone

Has this person been recognised with other awards?

Yes

Unsure

If this person has received other awards, please outline what they are

In no more than 100 words, please provide a brief description of the nominee's experience of homelessness.

The answer to this question is not judged. It is sufficient to describe the forms of homelessness the nominee has experienced (ie. rooming houses, rough sleeping, couch surfing).

In no more than 150 words, please describe the activity or activities for which this person is being nominated.

While each question contributes towards judging, it is not required in this award category to provide an answer to each question. Nominations for individuals who have achieved excellence in any of the selection criteria are encouraged.

In no more than 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.

In no more than 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.

In no more than 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.

This award category requires the consent of the nominee. I have shared this information with the nominee and gained their consent to submit it..

Yes

No, but I will provide this confirmation in the coming days

Name of reference 1

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Organisation of reference 1

Position of reference 1

Phone of reference 1

Email of reference 1

Name of reference 2

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Organisation of reference 2

Position of reference 2

Phone of reference 2

Email of reference 2

The nominee has agreed to be nominated for a Victorian Homelessness Achievement Award. They agree that the 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. They consent to the Council to Homeless Persons or its agents contacting the people named in this form and seeking comment from them regarding this nomination. They acknowledge that the Council to Homeless Persons will store this information securely.

The nominee has read this statement, or had it read to them, and agrees with the terms.

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 the 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 the 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 the Council to Homeless Persons will store this information securely.

If you are human, leave this field blank.

Victorian Homelessness Conference

The Victorian Homelessness Achievement Awards are announced at the Victorian Homelessness Conference.

Consumer Achievement Award

Consumer Achievement Award 2023

Victorian Homelessness Conference

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