Nomination Form Planning and Management Awarded for an outstanding planning document that implements clear direction for the protection, improvement and sustainable use/development of Victoria’s coastal and marine environment, or outstanding management activities that deliver enhanced protection, improvement and sustainable use of Victoria’s coastal and marine environment. Submissions in this category may include: planning documents (e.g. coastal management plan, tourism and visitation plan, planning scheme) policies/strategy (e.g. biodiversity strategy, land use strategy) management programs and projects on-ground management activities and works (e.g. protection, conservation, revegetation, rehabilitation) Nominations are encouraged from community groups, Coastcare groups, ‘friends of’ groups, partnerships, Committees of Management (CoMs), private companies, Traditional Owners, not-for-profit organisations, and local and state government departments and agencies. Previous Winners 2013 Wellington Shire Council Awarded for the Ninety Mile Beach Plan 2012 City of Port Phillip Awarded for the Port Phillip Foreshore Management Plan 2011 The Port Phillip Bay (Western Shoreline) and Bellarine Peninsula Ramsar Site Steering Committee Awarded for the partnership working together for the Port Phillip Ramsar Site Before completing this form please read the Nomination Guidelines and entry Terms and Conditions available at www.vcc.vic.gov.au. Completed nomination forms and supporting material are to be emailed to coastal.awards@delwp.vic.gov.au. For enquiries, please contact the Awards team via email or phone on 03 9637 8942. Nominations close midnight, Sunday, 2 August 2015. Late submissions will not be accepted. Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 1 of 9 Nomination Details Project Title Name of group or organisation Street Address City or Town Postcode Contact person Position Mobile contact number Email address Website (if applicable) Social media (if applicable) Nominator Details Title (please circle) Mr Ms Miss Mrs Dr Name of nominator Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 2 of 9 Please complete this section if the group’s work was developed or implemented in partnership with another organisation or individual. Partner One Title (please circle) Mr Ms Miss Mrs Dr Name Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Briefly outline the nature of the partnership as it relates to the nomination Partner Two Title (please circle) Mr Ms Miss Mrs Dr Name Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 3 of 9 Briefly outline the nature of the partnership as it relates to the nomination Nomination Summary Please provide in 250 words or less a summary of the nomination. Please note that this summary may be used in promotional material for the awards, including media releases and on the VCC website. The summary should reflect the intrinsic nature of the award entry. Previous Award Declaration Has the nomination previously received an award? Yes No Name of Award Presented by Date received Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 4 of 9 Key Selection Criteria Response to each question must be less than half a page Point form is encouraged 1. For planning documents please provide details about how the planning document implements clear direction for the protection, improvement and sustainable development of Victoria’s coastal and marine environments. List key outcomes to date and anticipated future outcomes. or For management activities please provide details about how the management activities have enhanced protection, improvement and sustainable use of Victoria’s coastal and marine environments. List key outcomes to date and anticipated future outcomes. 2. Describe the nature and level of engagement and collaboration with stakeholders and the broader community. Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 5 of 9 3. Explain how the initiative demonstrates leadership and best practice in coastal planning or management. 4. Provide details about the potential for the initiative to be applied elsewhere. Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 6 of 9 5. Explain how the initiative aligns with other relevant coastal and marine plans, policies, strategies or mandates. Please include the name of any relevant documentation within your answer. Please provide two referees this may include yourself as the nominator but may not include the nominee. One referee must be independent of the project being nominated. Referee One Title (please circle) Mr Ms Miss Mrs Dr Name Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 7 of 9 Referee Two Title (please circle) Mr Ms Miss Mrs Dr Name Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Award Recipient Provide the name and contact details of the person(s) who will accept the award on presentation night if successful. Title (please circle) Mr Ms Miss Mrs Dr Name Street Address City or Town Postcode Phone number Mobile phone number Email address Position (if applicable) Organisation Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 8 of 9 Images and supporting material Images and supporting material that demonstrate the success of the nomination are highly encouraged. The submission, including attachments may not exceed 5MB and may only include 5 images. If there is a requirement to provide large attachments or high resolution photographs, please supply these via post on a USB to: Victorian Coastal Awards for Excellence 2015 Victorian Coastal Council PO Box 500 East Melbourne Victoria 8002 Correspondence from the Victorian Coastal Council All correspondence from the Victorian Coastal Council should be addressed to (please mark the box with an ‘X’): Contact details for nominator Contact details for nominee Both of the above Terms and Conditions By marking this box an ‘X’ I indicate that I have read and agree with the Victorian Coastal Awards for Excellence Terms and Conditions of entry and the Privacy Statement, found on the Victorian Coastal Council website. Name Signature Date Victorian Coastal Awards for Excellence 2015 Nomination Form – Planning and Management Page 9 of 9