ACTIVE WORKPLACES 2023 AWARDS NOMINATION FORM

Nominations are to be submitted online by answering the following questions:

Award Nominations

Organisation Name:(Required)

Organisation Size (number of employees):(Required)

Organisation Size (number of employees):

Is your organisation registered with the Healthy Workplaces Achievement Program?(Required)

Yes

Is your organisation registered with Active Geelong?(Required)

Yes

Key Contact Person:(Required)

Key Contact Email:(Required)

Key Contact Phone:(Required)

My organisation wishes to nominate for the following Active Geelong Active Workplaces Awards (tick box):(Required)

GOLD Award: Active Geelong Active Workplaces Active Workplace of the Year

SILVER Award: Active Geelong 2023 Active Workplace Award – Active Culture

SILVER Award: Active Geelong 2023 Active Workplace Award – Active Physical Environment

SILVER Award: Active Geelong 2023 Active Workplace Award – Active Opportunities

SILVER Award: Active Geelong 2023 Active Workplace Award – Active Community Connections

Active Culture Questions

Please only answer the ‘Active Culture’ questions below if are nominating you are workplace for the GOLD Active Workplace of the Year OR SILVER Active Workplace – Active Culture Award

Active Culture: With reference to the Award Criteria, describe using examples how your workplace demonstrates an ‘active culture’?(Required)

Active Culture: Please upload any material that further strengthens your workplaces nomination

Drop files here or

Max. file size: 10 MB.

This could include documents, photos or videos.

Active Physical Environment Questions:

Please only answer the ‘Active Physical Environment’ questions below if are nominating you are workplace for theGOLD Active Workplace of the Year OR SILVER Active Workplace – Active Physical Environment Award

Active Physical Environment: With reference to the Award Criteria, describe using examples how your workplace demonstrates an ‘active physical environment?(Required)

Active Physical Environment: Please upload any material that further strengthens your workplaces nomination

Drop files here or

Max. file size: 10 MB.

This could include documents, photos or videos.

Active Opportunities Questions:

Please only answer the ‘Active Opportunities’ questions below if are nominating you are workplace for theGOLD Active Workplace of the Year OR SILVER Active Workplace – Active Opportunities Award

Active Opportunities: With reference to the Award Criteria, describe using examples how your workplace demonstrates ‘active opportunities’?(Required)

Active Opportunities: Please upload any material that further strengthens your workplaces nomination

Drop files here or

Max. file size: 10 MB.

This could include documents, photos or videos.

Active Community Connections Questions:

Please only answer the ‘Active Community Connections’ questions below if are nominating you are workplace for theGOLD Active Workplace of the Year OR SILVER Active Workplace – Active Community Connections Award

Active Community Connections: With reference to the Award Criteria, describe using examples how your workplace demonstrates an ‘active community connections’?(Required)

Active Community Connections: Please upload any material that further strengthens your workplaces nomination

Drop files here or

Max. file size: 10 MB.

This could include documents, photos or videos.

Is there anything further you wish to tell us to support your workplaces nomination for the 2023 Active Gelong Active Workplace Award?(Required)

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ACTIVE WORKPLACES 2023 AWARDS NOMINATION FORM

Award Nominations

Active Culture Questions

Active Physical Environment Questions:

Active Opportunities Questions:

Active Community Connections Questions: