Teacher Details

First Name

Last Name

Email (Please use your education email address only)

Phone

Position Title

School Details

Find your school

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School Name

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School Details

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Indigenous Enrolments (%)

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ACARA SML ID

Federal Electorate

Total Enrolments

ICSEA Score

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Language Other Than English

COLLECTION NOTICE: The Australia Olympic Committee (AOC) collects your personal information in order to facilitate your school’s registration for the Olympic Change-Maker program (Program) and to communicate with you about other AOC community programs and education resources. Without this information, your school would not be able to participate in the Program. The AOC collects, uses, discloses, stores and protects your personal information in accordance with our Privacy Policy. This Privacy Policy outlines how to access and/or correct your personal information or make a privacy related complaint.

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Student 1 Details

Tell us more about a student you believe demonstrates the Olympic Spirit in their actions!

Student First Name

Student Last Name

Student Email

Year

Student Date of Birth (dd/mm/yyyy)

In 100 words or less, please advise why you are nominating this student for the Australian Olympic Change-Maker Award i.e. describe how they are demonstrating leadership and/ or creating change.

Parent/Guardian Details

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Mobile

You may nominate up to two students for the 2024 Australian Olympic Change-Maker Award, would you like to nominate a second student?

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Student 2 Details

Tell us more about another student you believe demonstrates the Olympic Spirit in their actions!