Online Nomination Portal

Complete the form below to nominate an individual or institution that exemplifies integrity.

Selection Process

The credibility of the Scheme depends on a fair, transparent and independent assessment process. Each nomination undergoes:

Administrative ReviewVerification of eligibility and supporting documentation.
Technical EvaluationIndependent assessment using approved scoring criteria.
Due DiligenceVerification of claims and background information.
Committee ReviewRecommendations are considered and approved.
Final ApprovalSuccessful nominees are confirmed before public announcement.

SECTION A: AWARD CATEGORY

Please tick (✔) the appropriate award category:

SECTION B: NOMINEE INFORMATION

1. Full Name of Nominee *

2. Gender

3. Date of Birth

4. Nationality

5. Current Position/Occupation

6. Institution/Organisation

7. Postal Address

8. Region

District / Town / Location

9. Telephone Number(s)

10. Email Address

SECTION C: DETAILS OF NOMINATOR

1. Full Name of Nominator *

2. Organisation (if applicable)

3. Relationship to Nominee

4. Postal Address

5. Telephone Number(s)*

6. Email Address *

SECTION D: BASIS FOR NOMINATION

Please attach all relevant supporting documents/testimonies where available such as a citation, video, photos or media coverage or any other relevant written documentation.

1. Ethics – Report unethical behaviour

Describe one (1) instance where the individual reported unethical behaviour.

2. Ethics – Insisted on policy/procedure despite opposition

Provide two (2) examples of occasions when the individual insisted on policy/procedure being followed even in the face of opposition.

3. Ethics – Impact of the action

What was the impact of this action (from question 2)?

4. Courage – Personal cost paid

Describe the personal cost they paid for doing the above (questions 1–3).

5. Integrity – Kept promise even when inconvenient

Describe two (2) circumstances where the individual kept their promise even when inconvenient.

6. Integrity – Followed procedure

Provide two (2) examples of occasions where the individual followed procedure.

7. Honesty – Acted honestly

Provide one (1) example of a situation where the individual acted honestly.

8. Honesty – Admitted to an error

Provide one (1) example of a situation when the individual admitted to an error on their part.

9. Inclusiveness – Gave everyone a voice

Provide one (1) example where the person gave every person in a space the opportunity to have their voice heard.

10. Gender Responsiveness – Treated men and women equally

Provide one (1) example where the person treated both men and women equally.

11. Transparency – Demonstrated transparency in decision-making

Provide two (2) examples where the person demonstrated transparency in decision-making.

12. Accountable Leadership – Allowed decisions to be scrutinised

Provide two (2) examples where the person allowed their decisions to be subjected to scrutiny.

SECTION F: REFEREES *

Please provide details of three referees who can verify the information contained in this nomination. Full Name and Telephone Number are required for each referee.

REFEREE 1 *

Full Name *

Position/Title

Institution/Organisation

Telephone Number *

Email Address

Relationship to Nominee

REFEREE 2 *

Full Name *

Position/Title

Institution/Organisation

Telephone Number *

Email Address

Relationship to Nominee

REFEREE 3 *

Full Name *

Position/Title

Institution/Organisation

Telephone Number *

Email Address

Relationship to Nominee

Declaration by Nominator: I hereby declare that the information provided in this nomination form and in the accompanying documents is true and accurate to the best of my knowledge and belief. I understand that the National Integrity Awards Committee reserves the right to verify any information submitted and to disqualify any nomination where material falsehood, misrepresentation or ineligibility is established. *

Online Nomination Portal

Selection Process

Prefer to submit offline?

SECTION A: AWARD CATEGORY

SECTION B: NOMINEE INFORMATION

SECTION C: DETAILS OF NOMINATOR

SECTION D: BASIS FOR NOMINATION

SECTION E: SUPPORTING EVIDENCE

SECTION F: REFEREES *

REFEREE 1 *

REFEREE 2 *

REFEREE 3 *