Recognition of Service

The form below accompanies Council's Community Recognition Policy(PDF, 827KB).

Applications for recognition must be sent with at least 21 days notice prior to any celebration event (or 6 weeks for 100 year milestones)

Organisation Details

Name of Organisation

Address of Organisation

ABN or Incorporation No.

Contact Person Details (certificates will be mailed to this contact)

Name

Address

Phone Number

Email * (required)

Milestone for Recognition

Which milestone or achievement are you celebrating? (Please refer to Council's Community Recognition Policy - Organisations for information on what is available for each milestone)

25 years of operation
50 years of operation
75 years of operation
100 years of operation
Other Achievement (number of years in operation - see below)

Other Achievement - Provide a brief explanation (or please attach further information if needed)

How is your year of commencement determined? (ie. since incorporation)

Celebration Event

Date of EventDate of Event

RadDatePicker

Open the calendar popup.

Calendar

Title and navigation
Title and navigation
<<	<	July 2026	>	<<

July 2026
	M	T	W	T	F	S	S
27	29	30	1	2	3	4	5
28	6	7	8	9	10	11	12
29	13	14	15	16	17	18	19
30	20	21	22	23	24	25	26
31	27	28	29	30	31	1	2
32	3	4	5	6	7	8	9

Time of Event

Address where Event is to be held

Description of Event

Representation from the Mayor

If you are celebrating 25, 50, 75 or 100 years, would you like to request the attendance of the Mayor or his/her representative to present your plaque?

Tick to confirm declaration * (required)

I declare that the above information I have provided is true and correct

Contact Council

Business Hours
Monday-Friday 8:45am - 4:45pm
Closed Public Holidays

Phone: (03) 6430 5700
Email: burnie@burnie.tas.gov.au

Burnie City Council
PO Box 973
80 Wilson Street
Burnie, TAS 7320

ABN: 29 846 979 690

Acknowledgement of Country

Burnie City Council acknowledges that every part of Australia is, always was and always will be, Aboriginal land. Burnie City Council pays respect to the pakana/palawa – original owners and cultural custodians – of all the lands and waters across trouwunna/lutruwita/Tasmania upon which pataway/Burnie is situated and where our Council meets.

Above: Aboriginal and Torres Strait Islander flags

Privacy | Sitemap | TIS - Translating and Interpreting Service