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Plaque scheme nomination form

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Home > Library > Local history > Woollahra Council Plaque Scheme > Nominate a person or event > Plaque scheme nomination form

About this form

Having made certain that your idea for a plaque meets the full criteria for nomination, a formal nomination may be submitted using this form.

Documentation

Please complete the following questions. Eligible nominations will be researched by the Local History librarian.

Lodgement and fees

There is no cost associated with lodgement of a plaque nomination.

Any questions

Please contact Woollahra Libraries on 9391 7100 or email localhistory@woollahra.nsw.gov.au

Details of nomination

* indicates required field

Name of the person or historical event you are nominating for a plaque *

Birth and death dates of the person

Reasons why the nominated person or historical event deserves a plaque *

Information about the person's life and achievements or the historical event *

List of Woollahra Local Government Area addresses associated with the subject being nominated, with dates of occupation or association *

Details of applicant

Family name *

Given names *

Postal address *

Postcode *

Phone (1) *

Phone (2)

Fax

Contact person (only if a company etc)

Privacy notification

The personal details requested on this form will only be used for the purposes of Plaques Scheme criteria assessment. The supply of information by you is voluntary. If you cannot provide or do not wish to provide the information sought, your application may not be processed. Access to the information is restricted to Woollahra Council. Council is to be regarded as the agency that holds the information. You may make application for access or amendment to information held by Council.

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