Irene Juergens (IJ) Fellowship Award

Data Processing Consent

The following consent is required before you can proceed with your submission for Rotary NSW Police Awards 2026. Please note that if you do not give consent for your details to be used by the organisers, we will not be able to contact you regarding the planning and conduct of the Conference. As a result, you will not be able to proceed with your submission for Rotary NSW Police Awards 2026 and will be re-directed back to the main website.

I give consent for my data to be used in planning and conduct of Rotary NSW Police Awards 2026 including arrangements for my participation by the event organiser

I do not give consent for my data to be used in planning and conduct of Rotary NSW Police Awards 2026 including arrangements for my participation by the event organiser

Submitter Details

Title

Given Name

Family Name

Company / Organisation

Email Address

Verify Email Address

Mobile Phone

Title of the person you are nominating

Full name of the person you are nominating

Reason for nomination (maximum 500 words)

Maximum 500 words in the space below. Provide as much details/information as possible within the space about why and how this person has served his/her community over and above his/her usual job/role. Please note, what you can tell the judging panel will greatly assist them with their decision. You can cut and paste from another document.

Relationship to nominee

Nominees phone number (mobile preferred)

Nominees Command/Business Unit

Rank

Are they a Local Rotary Police Award Winner?

As you have selected 'Yes' to the above, please specify club and award title

Sworn or Unsworn?

As you have selected 'Sworn' to the above, please provide the 5 digit number

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Data Processing Consent

Submitter Details