Certificates of Appreciation

Certificate in Recognition of Service to Australia during:


Section A - Person whose name will appear on the Certificate

* Indicates required field


Section B - Details of person making the nomination

If you are applying for yourself, please go straight to Section C. If you are applying on behalf of another person, please complete Section B

Are you making an application for a posthumous award?
YesNo


Section C - Details of Service

Type of contribution or service *



Section D - Submission of Application

Evidence of Service
Please upload one of the following as evidence of service:

  • Service Record showing service in the relevant period and, for post World War II certificates, service in the relevant country during the period of conflict; or
  • Service Record showing eligibility for medal(s) for the relevant conflict; or
  • Photographs/Photocopies of Medal(s) for the relevant conflicts, inscribed with the veteran’s name and service number; or
  • Copies of entries from the World War II, Korean War and Vietnam War Nominal Rolls; or
  • In the case of applicants for a World War II certificate, evidence or a Statutory Declaration attesting to service on the home front.

If you would prefer to post or hand deliver evidence of service documents, please either mail documents to:
Julia Banks MP
PO BOX 102
Burwood 3125

OR visit the office at:
Level 1, 140 Burwood Highway
Burwood 3125


I hereby declare by submitting this document that the information supplied by me in this form is complete and correct.


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