Azra Ahmed Award – Nomination Form

Person nominating

First Name

Last Name

Email address of nominator:

Phone number of nominator:

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Your relationship to the nominee:

Name of person endorsing the nomination

Note: All nominations must be endorsed by someone who knows the nominee in a public or community role.

Public/Community Role of the endorser:

Relationship between the nominee and the endorser:

Email address of endorser:

Phone number of endorser:

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Name of the nominee

First Name

Last Name

Email address of the nominee

Phone number of the nominee

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Eligibility Check 

Does the nominee meet all of the following criteria?

Muslim woman

Residing in Sydney

Aged 18–30

From the Indian subcontinent

Lived experience as a first-generation migrant

Nomination Statement

Describe why the nominee should be considered for the Azra Ahmed Award. Please include specific examples of her contributions, achievements, or impact. (500 words limit)

Nominee Consent Confirmation

“I confirm that I have obtained the nominee's consent to submit this nomination.”