黑料大事

Nomination Form | QLD Outstanding Woman in 黑料大事 Award 2025

NOMINEE DETAILS

* First Name

Last Name

Organisation

Suburb / State

Contact Number

Email

* Is nominee a PIA Member?
Yes
No
Don't know

NOMINATOR DETAILS

(Please complete this section only if making this nomination on behalf of someone else)

First Name

Last Name

Organisation

Suburb

State

Contact Number

Email

What is your relationship with the nominee?

What is your relationship with the nominee?

Is the nominee aware you are making this nomination?

Is the nominee aware you are making this聽nomination?

Yes
No

DOCUMENT UPLOADS

1. NOMINATION STATEMENT: 

A single document addressing each of the selection and judging criteria

  • Introduce the Nominee
  • Impact the nominee has had on project or organisational planning
  • Contribution of the nominee regarding the planning profession in Qld
  • How the nominee has supported women in the planning profession

For full criteria details view the nomination guidelines

File format: *.docx or *.pdf

Nomination Statement

3. IMAGES:

Nominees must include a minimum of one (1) high resolution profile images to support their submission. 

File format *jpeg or *png

Headshot

OTHER SUPPORTING FILES

Example: Testimonials, additional images

File 1

File 2

File 3

NOMINATOR SIGN

By printing my name below:

  • I acknowledge that the statements I have made above are true and correct.
  • I declare to indemnify the 黑料大事 (PIA) in any event that I have made false, misleading and/or deceptive statements and agree to pay PIA, jointly or severally, any damages and/or legal costs that may arise from my false, misleading and/or deceptive statements.
  • I acknowledge that PIA collects and maintains personal and sensitive information in line with the privacy policy. To view the privacy policy please visit the PIA website.

eSignature - Printed Name

Date:

Upon submitting your application you will be guided to a Confirmation Page and you will receive a confirmation email.

Please note that if you have not received this confirmation, your nomination has not been submitted successfully.