Holroyd Heritage Awards 2015 Official Entry Form for Category 3 HistoResearch: researching our local history – this category is open to anyone of high school age and above who is interested in local history and heritage. To commemorate the Centenary of World War One, participants are invited to research a local person, group or aspect of Holroyd’s history that relates to the war effort. Entrants are encouraged to be imaginative and present their work in either a written or visual format that utilises a creative technique such as digital media. Entries must show originality and a high level of primary research. General Name of nominee: _______________________________________________________ ____ Address of nominee: _______________________________________________________ __ _______________________________________________________ ____________________ Phone: _____________________________ Fax: ____________________________________ Email: ______________________________________________________________________ Category 3 – HistoResearch: researching our local history Name of research project: _____________________________________________ ________ __________________________________________________________________________ _ Does the project relate to the theme and Holroyd’s history? Yes No Owner’s Consent (if nominee is not owner) As the owner of the subject research project, I give permission for ___________________________________________________________________________ to nominate my work in the Holroyd Heritage Awards in 2015. Signature of all owners: ______________________________________________________ _ Nominee’s Consent I have read and understand the aims and conditions of entry listed on the back of this form and understand the responsibilities for entry to the Holroyd Heritage Awards. I acknowledge that Holroyd Council has the right to ownership of all entries, and may use my entry for promotional and other purposes. Signature of nominee: ____________________________ Date: ___________________ Entries close Tuesday, 26 May 2015 Please see the reverse for Conditions of Entry and submission methods. Page 1 of 3 Conditions of Entry for Nominees 1. Category 3 Aims: (a) (b) (c) (d) (e) The work makes a substantial contribution towards preserving, enhancing, interpreting or highlighting Holroyd’s heritage. The individual or group has made an extraordinary effort with regards to heritage. The work can include written and art works, heritage studies , archaeological preservation, or any other effort in the heritage field. The work raises awareness and understanding of Holroyd’s heritage. The work displays an outstanding appreciation of heritage. 2. Nominees’ Responsibilities: 1. 2. 3. 4. 5. 6. 7. 3. (a) (b) (c) (d) (e) (f) Fill in the standard nomination form. Submit the nominated work or details of the work with the completed nomination form. Ensure that the nominee is at least 14 years of age. Ensure that the work is related to an element of Holroyd’s history and heritage. Ensure that the owner of the work has given permission for the work to be nominated for this award. Only one (1) entry is permitted per person or organisation (i.e. historical society, research group, etc). Content must demonstrate that an element o f primary research has been undertaken; that the content is the original work of the entrant; and any information sources are appropriately reference. All Categories The decision of the Judging Panel will be final. If you have not heard back from Council by August 2015 regarding your nomination, then you can consider that your nomination was unsuccessful this time. All nominations and supporting material will be retained by Holroyd Council and may be used for promotional and other purposes at the discretion of Council. It is expected that nominations will be competitive and there is no guarantee that you will receive an award if you make a nomination. Details regarding individual scores given by Judges for each nomination and award will not be released to nominees or the public. By entering these awards you agree to these conditions. Please attach additional information, photos, plans or work , etc. you want to submit in support of your nomination to this form when you make your nomination . Where to send this nomination form You should send your complete nomination to: The General Manager, Holroyd City Council Hand Deliver: 16 Memorial Avenue, Merrylands Post: PO Box 42, Merrylands NSW 2160 Email: hcc@holroyd.nsw.gov.au Entries close Tuesday, 26 May 2015 Please contact Council on 9840 9840 if you require further information or visit www.holroyd.nsw.gov.au Holroyd City Council 16 Memorial Avenue MERRYLANDS 2160 Page 2 of 3 PRIVACY NOTE: Council will collect and hold the personal information contained in this application for the purpose of processing and considering the application. The intended recipients of the personal information are officers within Council. The supply of personal information by you is voluntary, however if you cannot provide, or do not wish to provide the information sought, Counc il may be unable to process your application. You may make an application for access or amendments to your personal information held by Council under the Privacy and Personal Information Protection Act 1998 (PPIP Act) or the Government Information (Public Access) Act 2009 (GIPA Act). You may also request that Council suppress your personal information from a public register. Council will consider any such application in accordance with the PPIP Act. Information provided to Council in correspondence, submissions or requests, including your personal information, may be made publicly available, including on Council’s website, under the GIPA Act. Please notify us if you object to the disclosure of your personal information. Page 3 of 3