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ASA Medal Nominations Form

Please read the ASA Medal Terms and Conditions before completing the nomination form. Any nominations that do not meet the terms and conditions will not be considered.

Nominations can only be received by current ASA members. You will need your membership number when completing this form, which can be found in 'My Account' here.

Nominator Information
* Name of nominator:
* Membership number:
* Nominator phone:
* Nominator email:

Nominee Information
* Person nominated:
* Nominee phone:
* Nominee email:

Reason for nomination: Please explain in 500 words or less the person's significant contribution to Australian culture as both a creator and an advocate including, but not limited to, work which supports, encourages or fosters writing or illustrating. 
* Reason for nomination:

I have read and agree to the terms and conditions of nomination.
* Agreement:


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The ASA acknowledges the Gadigal people of the Eora nation, the Traditional Owners of the land on which we meet and work, and all Traditional Owners of country throughout Australia. We recognise Aboriginal and Torres Strait Islander peoples' continuing connection to land, place, waters and community. We pay our respects to their cultures, country and elders past present and emerging.


The ASA respects Australia's first storytellers.



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