Distinguished Service Medal (DSM) Nomination Form

Page 1

The Duke of Edinburgh's International Award - Australia
Recipient Details






Application Details

Recipient Award Service History
Upon completion of this form, you must upload substantiating documentation to verify eminent and/or exceptional service and achievement for each new role or type of service and achievement. This includes evidencing financial or in-kind contributions. Supporting documentation is mandatory for a nomination to be considered. Please refer to eligibility criteria on the website if unsure. 





List supporting documentation to be uploaded

Nominator & Referee Details

Nominator Details
Note: The nomination is being made to the National Medals & Awards Committee who approve medals on behalf of the National Board.









Referee 1








List and upload at the end of the form
Referee 2








List and upload at the end of the form
Supporting Documentation