Minister for Health and Wellbeing Excellence in Public Health Awards 2021 Application Form Page 1 of 5 Applications close on Friday 3 September 2021. Please note that the person whose contact details are provided with your council’s application will be the main contact for administration purposes. Please type your details into this form and, once complete, press the ‘email’ button at the end of the form. Your form will be sent to Local Government Relations and Policy at SA Health. Please ensure you save work as you go and print your form for your own records. Please note that forms are compatible with Internet Explorer but may not work in other browsers. If using a different browser, please save the form and work from your desktop. Alternatively, you can print your form and send it by post, to be received on or before close of business on Friday 3 September 2021. If you are using the digital signature option and have not completed an electronic signature before, please follow these steps: 1. Click on the signature field. 2. Select ‘A new digital ID I want to create now’. 3. Select ‘Windows Certificate Store’. 4. Complete your details only – there is no need to change the options after the ‘country’ field. 5. Click ‘finish’. 6. Click ‘sign’. 7. At this point, you will be asked to save your document. This will happen each time the form is signed. Further enquiries and application forms to: Local Government Relations and Policy, SA Health Phone: 8226 6238 Email: [email protected]Post: Level 4, 11 Hindmarsh Square ADELAIDE SA 5000 Please note: it is your responsibility to refer to eligibility and conditions of entry in the Nomination Guide prior to completing your form. The judging panel will assess how closely your application meets the award criteria. Although optional, you are encouraged to incorporate media to support your application, such as photographs, newsletter articles and newspaper clippings.
Transcript
Minister for Health and Wellbeing Excellence in Public Health Awards 2021
Application Form
Page 1 of 5
Applications close on Friday 3 September 2021.
Please note that the person whose contact details are provided with your council’s application will be the main contact for administration purposes.
Please type your details into this form and, once complete, press the ‘email’ button at the end of the form. Your form will be sent to Local Government Relations and Policy at SA Health. Please ensure you save work as you go and print your form for your own records.
Please note that forms are compatible with Internet Explorer but may not work in other browsers. If using a different browser, please save the form and work from your desktop.
Alternatively, you can print your form and send it by post, to be received on or before close of business on Friday 3 September 2021.
If you are using the digital signature option and have not completed an electronic signature before, please follow these steps:
1. Click on the signature field.
2. Select ‘A new digital ID I want to create now’.
3. Select ‘Windows Certificate Store’.
4. Complete your details only – there is no need to change the options after the ‘country’ field.
5. Click ‘finish’.
6. Click ‘sign’.
7. At this point, you will be asked to save your document. This will happen each time the form is signed.
Further enquiries and application forms to:Local Government Relations and Policy, SA Health
Post: Level 4, 11 Hindmarsh Square ADELAIDE SA 5000
Please note: it is your responsibility to refer to eligibility and conditions of entry in the Nomination Guide prior to completing your form.
The judging panel will assess how closely your application meets the award criteria.
Although optional, you are encouraged to incorporate media to support your application, such as photographs, newsletter articles and newspaper clippings.
Minister for Health and Wellbeing - Excellence in Public Health Awards 2020
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Application type Metropolitan Regional
Council Name: ..............................................................................................................................................................................................................................................
Name of initiative: ........................................................................................................................................................................................................................................
SummaryBriefly describe your council’s SINGLE initiative. Include its purpose, key things you did, and what your council did to support/lead it (i.e. back the initiative to begin with, and ensure its success). Explain why your council’s initiative is an example to other councils of excellence in public health. (Word limit: 400)
A: STRATEGIC VALUE1. What local public health priorities identified in your Regional Public Health Plan does the initiative address? (Word limit: 250)
Minister for Health and Wellbeing - Excellence in Public Health Awards 2020
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2. Describe the benefit/change you are trying to achieve, why, and what success would look like (including, if possible, your measures of success). (Word limit: 400)
3. Which of the four priorities of the State Public Health Plan 2019-2024 does the initiative address and how? (More than one option can be selected) (Word limit: 150)
PROMOTE – build stronger communities and healthier environments
PROTECT – against public and environmental health risks and respond to climate change
PREVENT – chronic disease, communicable disease, and injury
PROGRESS – strengthen the systems that support public health and wellbeing
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B: QUALITY OF DEVELOPMENT, DELIVERY, AND MEASUREMENT1. Consultation and engagement
Who, and how, were community and other key partners consulted and engaged in this initiative? (Word limit: 250)
4. Sustainability Explain how the initiative is sustainable/can be integrated into ongoing council business, and discuss future plans. (Word limit: 200)
Minister for Health and Wellbeing - Excellence in Public Health Awards 2020
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2. Implementation process
What did council do? Include highlights and learnings from implementation. (Word limit: 500)
3. Evidence Of Success (Word limit: 600):
a. What benefits were achieved for the community? (200 words)
Minister for Health and Wellbeing - Excellence in Public Health Awards 2020
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Please save the form and work from your desktop if required. You can email the form directly to [email protected]
b. If available, include evaluation data, and other evidence of the benefits achieved (eg community reach, community satisfaction,project’s short and/or longer-term impacts). (250 words)
Your details*I consent to this application and declare the information included in this form is correct.
Title Surname ........................................................................................Given name .........................................................................................
Position title: ....................................................................................................................................................................................................................................................
Postal address: ..............................................................................................................................................................................................................................................
Business telephone: ..................................................................................... Mobile telephone: ..........................................................................................................
* All fields (excluding mobile telephone) are mandatory in the “Your details” section on all applications.† If submitting electronically, please insert a digital signature. Instructions are available on the cover page of the application form.
c. Describe any benefits achieved for council and its partners (eg increased skill-building, internal leadership support,agency collaboration). (150 words)
