Nomination Form and Guide to making Nominations

Printed copies of the nomination form and guide are available from Members of Parliament or:

The Honours Secretariat
Cabinet Office
Parliament Buildings
Wellington
or by telephone (04) 817-9840.

The electronic nomination form is available in Adobe Acrobat PDF (33 kB) and Microsoft Word (76 kB)

Bravery Awards

A separate nomination form and guide for bravery awards are available from the Honours Unit.

Online Nomination Form

Section 1 – Information about the nominator – person making the nomination.

Section 2 – Information about the nominee - person you are nominating for a New Zealand Honour.

Section 3 – The nomination details. Please complete all of the sections below.

1. Describe the service and achievements of the nominee: *

2. Describe the contribution the nominee has made to one or more of the following; their local community, their region, New Zealand as a whole, and/or internationally: *

3. Describe what makes the nominee’s service and achievements stand out above and beyond that of their peers, or above and beyond what might reasonably be expected as part of their paid employment.: *

4. Describe how the nominee’s service and achievements are regarded by their colleagues, and whether they have been formally recognised by their colleagues or through other awards (e.g. life membership of an organisation, honorary doctorate, etc.): *

Positions or offices held by the nominee: *

Please set out the main positions or offices held by the nominee, and the period of service. For each position list the following: Organisation, Position, From date, To date/current, Paid/voluntary.

Section 4 – Checklist and Sending Application

Are your letters of support enclosed with this nomination?: *

Yes

Have you answered all the questions in section 3?: *

Yes

Have you re-checked your nomination and ensured all the compulsory information has been provided?: *

Yes

By submitting this form, I (enter full name), sign this document on

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Nomination Form and Guide to making Nominations

Bravery Awards

Online Nomination Form

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