History Awards nomination form

Use this form to submit an entry for a History Award.

First name*

Last name*

Street address*

Suburb*

Postcode*

Daytime contact number*

Email*

Photographers name (if known)

Please provide a caption or story*

What category are you entering?*

--please select--Category 1 - Stirling Memories: a photograph with storyCategory 2 - Stirling Memories: a photograph with a captionCategory 3 - Youth entry award: 16 - 18 years old

Please upload your photograph*

I declare that I have read the conditions of entry as set out by the City of Stirling and agree to abide by them. I understand that my entry will become part of the Stirling History Collection and may be used as required. If under the age of 18, I declare I have sought parental permission

Retype the numbers below:

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