Before completing this form please read the information provided insideunder ‘Important reading!’

I wish to nominate:

for this Award

Address of nominee

Telephone

Email

Details of person nominating the above

Name

Address

Telephone

E-mail address

Details of referee 1

Name

Address

Telephone

E-mail address

Details of referee 2

Name

Address

Telephone

E-mail address

2012 Nomination FormEvery Generation Positive Ageing Awards

Patron sponsor Principal sponsor Sponsors

Please arrange for the following to be completed by the nominee

I agree to be nominated for this Award. I have read the information provided overleaf and I am prepared to be interviewed for judging and to be available for publicity purposes if required.

Nominee’s Signature

Date

Any queries?Contact Celeste ProsserEvery Generation Festival Project Offi cerCOTA SATelephone (08) 8232 0422 Facsimile (08) 8232 0433 Country Free Call 1800 182 324Email cprosser@cotasa.org.au

Please return to:Every Generation AwardsCOTA SAGPO Box 1583 Adelaide SA 5001

Nominations must be received by close of business Friday 24 August 2012.

NOMINATION FORM

Please be sure to provide us with written details of your nominee’s achievements and contributions to the community.

Take the time to read through the ‘How to Nominate’ information (attached).

Tell us a clear story of why your nominee should be considered for an Award. Include photos when possible to support your nomination.

Every Generation Outstanding Achiever

beyondblue Every Generation Positive Images

SA Health Every Generation Intergenerational Award

Retirement Village Association Every Generation Active Lifestyle

Prime Medical Placements Every Generation Creative Arts

Resthaven Every Generation Physical Activity

Come and celebrate with us at our Gala Dinner

Positi ve Ageing Awards Presentati on DinnerTuesday 30 October 2012InterConti nental Adelaide BallroomNorth Terrace, Adelaide 6.30pm to 11pm$52 per ti cket ● includes pre-dinner drinks● a sumptuous dinner prepared by the talented InterContinental

Chefs using the best local produce ● complimentary selected beverages● a decadent dessert ● peti t fours and coff ee to fi nish the meal and complement this

fabulous evening. Dance to Adelaide favourite ‘Boris Loves to Boogie’. Master of Ceremonies, Tony Pilkington

Tickets on sale Monday 23 July from COTA SA For further details or informati on phone 8232 0422 or visit the website www.cotasa.org.au

Are you eligible?The Awards are open to South Australian individuals, groups and organisati ons. Previous Award recipients are not eligible for re-nominati on in the same category within fi ve years of winning an Award.

JudgingThe Judging Panel will include representati ves from diff erent community groups acti vely involved with older people. In special circumstances Finalists may be invited to att end an interview for judging purposes.

Nominati onsNominati ons are welcome from any member of the public and are to be made on the Awards Nominati on Form (overleaf). Judges will require the names of two referees in additi on to the nominator.

Publicity and promoti onIt is anti cipated that Finalists will make themselves available for interviews and/or photographs as part of the promoti onal acti viti es around these Awards.

Important reading!Nominati ons can be accepted for more than one Award category by ti cking each category box you are nominati ng for.

It is important that the nominees read the informati on contained in this brochure and sign in the designated spot.

It is essenti al that supporti ng writt en informati on, giving both a descripti on of the nominee and details of their acti viti es and achievements be included in the nominati on.

The Every Generati on Positi ve Ageing Awards recognise the importance of a philosophy of positi ve ageing.

The Awards acknowledge the contributi ons of older individuals as well as programs, projects and organisati ons which realise and exemplify positi ve ageing. Just as people of all ages acti vely enjoy what interests them, many people experience ageing as an enjoyable, positi ve and valued experience. Notwithstanding disability and frailty, ageing is a ti me of personal fulfi llment as well as a ti me of ongoing contributi on to family and society. Award nominees will clearly care about older people and exhibit positi ve atti tudes, a love of life, and a concern for others.

Award categories

Every Generati on Outstanding Achiever Award

This Award recognises the outstanding achievement and service to the community by an older person. It honours an individual who through their life and contributi ons portrays positi ve ageing values and atti tudes.

The award acknowledges:

> a person over 50 whose eff orts and involvement in a voluntary capacity have benefi ted the enti re community over many years

> a person who conti nues to contribute acti vely and selfl essly to their community, and whose excepti onal achievements are an inspirati on to all.

beyondblue - the nati onal depression and anxiety inti ti ati ve Every Generati on Positi ve Images Award

This Award, sponsored by beyondblue - the nati onal depression and anxiety inti ti ati ve, recognises programs and services which challenge stereotypic presentati ons of, and atti tudes towards, older people.

It acknowledges pro-acti ve and realisti c att empts to see or to create more diverse and positi ve images of ageing within the community.

This could include initi ati ves which either:

> demonstrate interacti ons with older people in a positi ve way off ering older people the opportunity to parti cipate in non-stereotypic acti viti es, or

> challenge ageing stereotypes through media presentati ons and promoti onal material.

SA HealthEvery Generati on Intergenerati onal Award

This Award, sponsored by SA Health, recognises programs in which both older and younger people parti cipate.

It applauds intergenerati onal initi ati ves within the community which foster interacti on between people of all ages and demonstrate positi ve ageing.

These intergenerati onal initi ati ves may be via:

> the educati on system(primary, secondary or terti ary)

> through community organisati ons including seniors clubs, community centres, service clubs, local government, aged care providers etc

> the business or corporate sector.

Prime Medical Placements Every Generati on Creati ve Arts Award

This Award, sponsored by Prime Medical Placements, recognises an older person or organisati on that has made an ongoing contributi on to the cultural life in South Australia through involvement in the creati ve arts.

The recipient will:

> have assisted others in their creati ve endeavours within the community

> conti nue to pass their creati ve knowledge on to others, including to younger generati ons

> have demonstrated an understanding of positi ve ageing values and ideals

The Creati ve Arts may include visual arts and craft s, music, dance, theatre, fi lm, photography, literature and community cultural development.

Resthaven Every Generati on Physical Acti vity AwardThis Award, sponsored by Resthaven Incorporated, recognises the outstanding contributi on by an individual (all ages) to encourage older people to remain physically acti ve.

The recipient will:

> have made a signifi cant contributi on to the delivery of physical acti vity opti ons for older people in the community

> have demonstrated a positi ve atti tude to physical acti vity, personal fi tness and ageing

> have exemplifi ed the correlati on between physical acti vity and wellbeing in ageing

> have demonstrated their willingness to ‘go the extra mile’ with their parti cipants. This could include:

● coordinati ng external social acti viti es for parti cipants

● the provision of up to date research material on physical acti vity and wellbeing

● a willingness to work with local health practi ti oners.

Reti rement Village Associati onEvery Generati onActi ve Lifestyle Award

This Award, sponsored by the Reti rement Village Associati on, recognises the outstanding achievements by a group or organisati on to encourage older people to remain physically, mentally or socially acti ve.

The recipient will:

> have facilitated others in achieving positi ve ageing acti viti es that enhance their wellbeing on an on-going basis

> have demonstrated a positi ve atti tude to promoti ng acti ve lifestyles that encourage, moti vate and support positi ve ageing

> have made a signifi cant contributi on to acti ve ageing within the community.

The Every Generati on Positi ve Ageing Awards recognise the importance of a philosophy of positi ve ageing.

The Awards acknowledge the contributi ons of older individuals as well as programs, projects and organisati ons which realise and exemplify positi ve ageing.

Just as people of all ages acti vely enjoy what interests them, many people experience ageing as an enjoyable, positi ve and valued experience, with the ti me for personal fulfi lment and ongoing contributi ons to family and community. Award nominees will clearly care about older people and exhibit positi ve atti tudes, a love of life and a concern for others.