"*" indicates required fields
Once application information is prepared use the form fields below to submit the application.
PLEASE NOTE you cannot save and come back to the application so make sure you have gathered the information as outlined in word format and any supporting documents (as docx or pdf) before beginning the application process.*
Fill in the fields and click the Submit button at the bottom and your application will be submitted with your supporting documents attached.
1. Closing date for applications is 16 December 2026.
2. Applicants/ nominees must be employed or registered as a volunteer with a Victorian Emergency Services Foundation member agency.