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CONSTABLE CARE
CHILD
SAFETY
AWARDS
2015
NOMINATION
FORM
Proudly presented by
CONSTABLE CARE
CHILD SAFETY AWARDS
2015
The Constable Care Child Safety Awards is an
independent awards program created by Constable Care
Child Safety Foundation to celebrate remarkable Western
Australians who are dedicated to protecting children and
teenagers from harm, and building safe communities.
This is the fourth year of the Awards and there are seven
Child Safety Awards in which to nominate. Each Award
has been designed to celebrate the endeavours and
achievements of those who promote and facilitate a
safer Western Australia for children and young people.
We invite nominations for individuals, groups and
organisations who have demonstrated outstanding
contributions in one or more of the following Award
Categories:
• Individual Awards
• Community Awards
• Government Award
• Education Award
Nominating for a Child Safety Award is simple; complete
the online form by visiting the official Child Safety Awards
website www.childsafetyawards.org.au. Alternatively, you
can download and print the nomination form and submit
the entry via email or post (details on page 14).
All Award winners receive a Child Safety service medal
and honour certificate. Thanks to the Awards program
partners, cash prizes of $1000 will be provided to each
of the Individual Award Category winners. An additional
cash prize of $2000 along with a media promotion
package in The West Australian newspaper, will be
awarded to the recipient of the Child Safety Award of the
Year 2015.
All shortlisted finalists will be profiled on the official Child
Safety Awards website www.childsafetyawards.org.au and
receive 2 complimentary tickets to attend the Constable
Care Child Safety Awards Gala Presentation Ceremony
to be held at Perth Convention & Exhibition Centre on
Saturday 1 August 2015.
Nomination Period Opens:
9am 30 March 2015
Nomination Period Closes:
5pm 15 May 2015
To book seats at the Gala Presentation Ceremony please
visit our website www.childsafetyawards.org.au.
For further information or enquiries please contact:
Emily Samuel
Events & Community Relations Coordinator
The Constable Care Child Safety Foundation
[email protected]
(08) 9272 0000
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Step 1 Provide Contact Details
Provide Details of the Nominee
(The person, representative or organisation you would like to nominate for an Award)
Title (Mr, Mrs, Ms, Dr, Other):
Gender:
First Name:
Surname:
Position:
Organisation:
Male
Female
Project/Program Title (if applicable):
Address:
WA
State:Postcode:
Suburb:
Email Address:
TAS
VIC
QLD
ACT
SA
NT
NSW
Website URL:
Tel (H):Tel (W):
Working With Children Check Card? Yes
Tel (M):
No
Card No.
Provide Details of the Nominator
(Your details – if different from above)
As above
Title (Mr, Mrs, Ms, Dr, Other):
Gender:
First Name:
Surname:
Position:
Organisation:
Male
Female
Project/Program Title (if applicable):
Address:
Suburb:
WA
State:Postcode:
Email Address:
Website URL:
Tel (H):Tel (W):
How did you hear about the Constable Care Child Safety Awards?
I wish to remain anonymous
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TAS
VIC
QLD
ACT
SA
NT
NSW
Tel (M):
Step 2
Award Category Selection
Please tick the Award(s) you would like to nominate for and then refer to the corresponding page to address the
Award selection criteria. Please complete the selection criteria that pertains to the Award you have selected.
You may nominate in more than one Award Category, however, you must then address the selection criteria that is
relevant to each of your chosen Awards. Any nominations submitted across multiple Award categories that do not
directly address each individual Award selection criteria will not be accepted.
Individual Awards
Community Awards
WA Child Safety Volunteer Award
WA Child Safety Community Award
WA Child Safety Employee Award
WA Child Safety Corporate Partnership Award
WA Child Safety Police & Emergency Services Award
Please see page 5 for the Award selection criteria
Please see page 5 for the Award selection criteria
Government Award
WA Child Safety Government Award
Education Award
WA Child Safety Education Award
Please turn to page 5 for the Award selection criteria
Please turn to page 5 for the Award selection criteria
Note: The winners of each of the Child Safety Awards listed above will be the finalists in the
Constable Care Child Safety Award of the Year 2015. A separate independent judging panel
will meet to assess the finalists and determine the recipient of the Award of the Year.
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Step 3
Award Categories & Selection Criteria
Please address the Award Selection Criteria for your chosen
Award Category in a separate electronic file (word doc, etc).
Individual Awards
Celebrate the vision and resourcefulness shown by
individuals who have gone to extraordinary lengths to make
a difference to the lives of Western Australian children and
young people. Their dedication and results in the area of
child safety are dramatic and inspirational.
WA Child Safety Volunteer Award
Acknowledge the contribution made to communities within
metropolitan or regional Western Australia by a child safety
project, program, campaign or partnership. The project,
program, campaign or partnership should be sustainable, or
replicable, and demonstrate positive outcomes within the
area of child safety.
WA Child Safety Employee Award
WA Child Safety Community Award
WA Child Safety Police & Emergency Services Award
WA Child Safety Corporate Partnership Award
Selection Criteria:
Selection Criteria:
Please address the following five selection criteria:
Please address the following five selection criteria:
1. Tell us about the individual, the role they play and their
commitment
1. Provide an overview of the project, program, campaign
or partnership
2. Detail the improvements and innovations the individual
has implemented to promote child safety and create
safer environments for children
2. Explain the need the project, program, campaign or
partnership has addressed
3. Outline the reason why the individual became involved in
creating positive change in the area of child safety
4. Explain how the individual utilised resources and worked
with others to maximise impact and adhere to a ‘best
practice’ approach
5. Support your nomination with evidence that
demonstrates the positive outcomes the individual has
been responsible for in the area of child safety
Government Award
Recognises a local, state or commonwealth government
department, or agency whose project, program or campaign
has positively impacted the lives of children and young
people in Western Australia.
3. Describe how the project, program, campaign or
partnership has improved child safety outcomes for
individuals, groups, and/or the community
4. Outline the sustainability of the project, program,
campaign or partnership and if it can be easily replicated
5. Support your nomination with evidence that
demonstrates the positive impact of the project, program,
campaign or partnership in the area of child safety
Education Award
Honours an education initiative that has had a significant
impact on the lives of Western Australian children and
young people by educating and empowering them in the
area of child safety.
WA Child Safety Education Award
WA Child Safety Government Award
Selection Criteria:
Selection Criteria:
Please address the following five selection criteria:
Please address the following five selection criteria:
1. Provide an overview of the initiative
1. Provide an overview of the nominated Government
project, program or campaign
2. Explain the need the initiative has addressed
2. Explain the need the Government project, program or
campaign has addressed
3. Describe how the Government project, program or
campaign has improved child safety outcomes for
individuals, groups, and/or the community
4. Outline the sustainability of the Government project,
program or campaign and if it can be easily replicated
5. Support your nomination with evidence that
demonstrates the positive impact of the Government
project, program or campaign in the area of child safety
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Community Awards
3. Describe how the initiative has educated and/or
empowered children and young people
4. Outline the sustainability of the initiative and if it can
be easily replicated
5. Support your nomination with evidence that
demonstrates the positive impact, reach and outcomes
the initiative has had in the area of child safety
Step 4 Supporting Documentation
To support your nomination we encourage all nominees to submit supporting documentation,
including logos, photographs, video footage and media clippings to assist the judging process.
All finalists will be required to submit the following list of supporting documentation for the
gala presentation ceremony and promotional activities.
Document Checkbox List:
Support Material
Completed and signed nomination form
Supporting video
Supporting photographs
Testimonials
Supporting media clippings
Other (please list)
Logo (.jpg or .eps)
_______________________________________
I wish to supply extra pages and/or supporting material electronically, via post or in person.
Step 5 Referees
Provide Referee Details
First Referee:
Title (Mr, Mrs, Ms, Dr, Other):
Gender:
First Name:
Surname:
Position:
Organisation:
Male
Female
Email Address:
Tel (H):Tel (W):
Tel (M):
Second Referee:
Title (Mr, Mrs, Ms, Dr, Other):
Gender:
First Name:
Surname:
Position:
Organisation:
Male
Female
Email Address:
Tel (H):Tel (W):
Tel (M):
Step 6 Declaration
I have read and accept all the Terms & Conditions as detailed on page 7
Print Name:..................................................................................................
Signature*:.........................................................Date:.................................
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Note:
* Signature not required when
filling form in electronically.
Step 7 Submission
Submit your nomination before the nomination period closes 5pm Friday 15 May 2015.
Postal nominations and additional supporting
material can be mailed to:
Constable Care Child Safety Awards
PO Box 462,
Maylands WA 6931
Delivered to:
Emailed to:
[email protected]
Visit the official website for more information and
online nominations:
www.childsafetyawards.org.au
Constable Care Child Safety Foundation
48 Sixth Avenue,
Maylands WA 6051
Terms & Conditions
1. Acceptance of a nomination for the Constable Care Child Safety Awards
is at the sole discretion of the Constable Care Child Safety Foundation
(CCCSF), to the extent that CCCSF can refuse to accept or reject any
nomination without providing a reason.
10. Awards are contingent upon the nominator permitting CCCSF or its agents
to publish sufficient information about the entry so that the general public
can understand it. This information may be used for promotional purposes
for the Awards.
2. CCCSF accepts no responsibility for Award nominations not received by the
nomination closing date.
11. Nominations may be submitted by a representative of a company/
organisation or individual who, working alone or in a team, are primarily
responsible for the project.
3. Award nominations must be submitted electronically via the online Award
Nomination Form at www.childsafetyawards.org.au, or submitted via this
Nomination Form or one downloaded from www.childsafetyawards.org.au
and posted to Constable Care Child Safety Awards, PO Box 462 Maylands,
Western Australia, 6931 or hand delivered to the CCCSF office located at
48 Sixth Avenue, Maylands, WA 6051.
4. Each postal submission may be accompanied by supporting materials such
as sound and/or a video recording on a separate CD/ DVD/thumb drive. All
nominations must include images of the nominated project, organisation
or individual in .JPG format. Videos must be presented in .mov/.avi/.
mpeg4 format. All supplementary material for postal submissions should
be saved on a CD/DVD/thumb drive and posted to CCCSF at the above
address, and at the expense of the nominator.
5. Nominators can enter in more than one Award, but can enter in each
Award only once. A separate nomination addressing the individual
selection criteria should be submitted for each Award.
6. The prize for each Award is determined by CCCSF.
7. The decision of the Award judges will be final and no correspondence will
be entered into.
8. The nominator acknowledges and agrees that CCCSF does not accept
any responsibility for errors or omissions reproduced in the presentation
or the nominee’s supplements, or for work lost, or damaged under any
circumstance.
9. Except for the finalists and winners, which will be retained by CCCSF,
all other nominations accepted into the Awards may be destroyed. The
nominator grants CCCSF permission to show contents taken from the
nomination at the Awards gala presentation event held on 01 August 2015
and at such other places and at times as deemed appropriate in the sole
discretion of CCCSF. No entry will be returned to the entrant.
12. Joint nominations that represent the work of several groups or
organisations are accepted. Where approval of accreditation is required
by either party, this will remain the sole responsibility of the nominator.
CCCSF will bear no responsibility for obtaining any correct accreditations
as to the origination of any nominations. Only one prize will be awarded
and this will be to the nominee.
13. Current CCCSF employees or their immediate family members are not
eligible to nominate. Former employees may nominate but may not
submit entries based on their work at CCCSF.
14. Entries must be in English.
15. The submission of all relevant information to the judges is the
responsibility of the nominator. However, judges may seek further
information or clarification if necessary.
16. The judges reserve the right not to select finalists or winners within
Categories or to move nominees within and between Categories.
17. CCCSF reserves the right to use at any time the information from the
entries including photographs in any marketing or public relations
promotion for the sole purpose of promoting CCCSF and the organisation’s
ethos. All rights are reserved.
18. CCCSF and the judges will use information disclosed in submissions and
entries for evaluating the nomination.
19. Information contained in the nomination may be used by CCCSF or its
agents in preparing press and promotional information describing the
nominees.
Conditions of Entry
1. It is a condition of nomination that you have read and accepted ALL Award
nomination rules and conditions.
6. The decision made by the Awards judges is final and no correspondence
will be entered into.
2. By submitting this nomination I agree that the information in this
nomination is true and correct as at the date the nomination was
submitted.
7. CCCSF accepts no responsibility for submissions not received by the closing
date.
3. By submitting this nomination I agree to all the Award rules and conditions
defined herein.
4. By submitting this nomination I agree that except for information clearly
labelled as confidential, all information contained in the nomination form
and supporting materials, including photographs, may be used by CCCSF
or its agents in preparing press and marketing materials to promote the
Awards and other times to promote CCCSF and its ethos.
5. CCCSF reserves the right to declare any entry ineligible if, in reasonable
opinion of CCCSF, the entrant/nominee is unable to represent or promote
the Awards in a satisfactory manner, of if it does not answer the criteria.
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8. Finalists and winners will be judged by a judging panel. Decisions will be
based on the following:
-
Answering all Award nomination form criteria
-
The relevance and accuracy of supporting materials such as promotional
material, sound and/or video files and/or photographs
-
Information provided in testimonials, references and by referees
-
Results of interview or site visits of finalists (undertaken only if/when
deemed essential by the judges)
THANK
YOU
AND
GOOD
LUCK
Thank you for taking the time to nominate in the
Constable Care Child Safety Awards 2015.
By doing so, you have contributed to raising the
profile of an important child safety ambassador,
program or initiative in Western Australia.
Nominations will be shortlisted in May and then
reviewed by expert judging panels throughout
June and July. A representative from the
Constable Care Child Safety Foundation will
contact you via the details provided on your
nomination form during this process.