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Recognition of Service Levels

Below are the levels of service recognition the LGA provides.

Elected Members - Recognition of 20 and above service

Recognising currently serving Elected Members who have served local government for 20, 25, 30, 35, 40, 45 or 50 years or more. Elected Member can be presented with this certificate at the next LGA networking Dinner of the AGM or OGM. (This includes Elected Members who have served local government as both a staff member and currently as an Elected Member.)

Elected Members – Recognition of 10 or 15 years service

Recognising currently serving Elected Members who have served local government for 10 or 15 years. This is certificate is posted to council.

Council Staff Recognition of 10 years and above service

Recognising council officers (staff) who have served local government for 10 years or more (full time equivalent). Service is recognised in 5 year increments (10, 15, 20, 25, 30, 35, 40, 45 or 50). This certificate is posted to council.

For assistance completing this form please contact Leeanne or Rebecca at

* Mandatory Field

Recipient Details
Please do not use capital letters
Name of person to receive award*

(Please add full name to be printed on certificate)

Post Nominals

Please provide any post nominal letters to be printed on the certificate (ie OAM)


Please write the full name of the recipient's council. (To be printed on the certificate.)

Month and year commenced in Local Government*
Category of Recognition of Service
Service to be recognised*
Recipient currently serving as*

Please select if the recipient is currently serving as an Elected Member or staff member to the council.

Service achieved as both an Elected Member and a staff member

If recipient has served as both an Elected Member and as a staff member for Local Government, please provide date ranges and names of each council represented.

Was the service continuous?*
Was the service completed at one council?*
If you answered no to either question above, please outline date periods completed and council name/s
Elected Members only - Certificate Presentation

Any Elected Members who have completed 20 years or more of service to Local Government are invited to be presented with their certificate at the next LGA Networking Dinner (held in conjunction with the LGA's AGM or OGM). 

If the Elected Member being nominated would be happy to receive their certificate at this event, please provide the additional requested details below. The LGA will then extend the invitation to the recipient closer to the event.

Would the nominated Elected Member like to receive the certificate at an LGA Networking Dinner?
Short Bio about the Elected Member

Please outline the person nominated key achievements and any other key information that will help inform the presenter about the nominated persons service to Local Government and the community they serve within. (Approx 2 paragraphs)

Please upload a profile picture of the nominated Elected Member. (Preferably a high resolution jpeg)

Certificates to be posted to Council

All other service certificates will be posted to council for presenting. Please nominate below your preferred date to receive the certificate by.  Please allow 4 weeks as a minimum for certificates to be delivered to your council.

Date certificate required.
Key contact person
Contact person lodging this form*
Contact email address*
Contact phone number*
If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.

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