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Heroes of Australia

dog64 - 3APPLICATION FORM

 

STEP 1.    
Complete the  Application Form (PDF)
Online Mobile Application

STEP 2.    
Complete and submit Design & Copy here

 

THANK YOU VERY MUCH FOR YOUR INTEREST IN HEROES OF AUSTRALIA

Please answer all the questions and provide one of the three support ID’s.  Failure to do so will only delay acceptance of your entry and leave open your name to be claimed jumped by someone else with the same handle.  If you do not have a nick name or online handle please leave blank. Names can be recorded with the either a middle name or and nick name

Please use this application form if the online process stalls.

 

 

ID NUMBER
Your security number will be used to unlock your account for editing and changes.

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Note: For inclusion of the Wall of Fame and to prevent identity theft the full name and Date of Birth of the applicant must be verified. All information will be stored off-line on secure servers in Australia. A persons name may be verified by Driver’s License or other creditable credential. Military, Police, Security services and other high risk personnel may use standard in-service identifiers and an on-line alias/aka/nick-name.

 

 

 


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Photo (Upload) Head & Shoulders

 

REAL NAME:

  Family Name

  Given Name

Middle name or initial

 

 

 

On-line alias

 

 

Verify Identity

 


 

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Which category do you wish to be placed
Principal skills:  Medicine, Military, Sports, Business, Trades

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Which subcategory best describes you
GP, S.A.S, AFL, Food, Building

 



 

 

 

Note: For inclusion on the NOWTOWN and PAGE68 directories, both free and paid for eCommerce sites, applicants must have an Australian Business (ABN) or Australian Company (ACN) number. There must be an applicant (by name for and on behalf of the “business), however verification of the name is not required.

 

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BUSINESS NAME:

Registered Name

 

 

ABN/ACN

 

 

Category

 

 

Sub-Category

 

 

 



 

 

 

 

 

 

 

 

 

NOTHING PAST THIS POINT WILL BE PUBLISHED UNLESS SPECIFICALLY REQUESTED
IMPORTANT NOTE: Special provision is made for high risk, security and services personnel
Goto (Mobile Compliant form)

 

 

 

 

 

 

 

 



 

 

 

Note:  It is important that Heroes of Australia and #Homesites is able to contact applicants quickly. Community applicants must provide a mobile telephone number (which will only ever be published with the owner’s consent) and services personnel must provide base number and their service email address.

 

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Date of Birth

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Email Address

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Mobile Telephone Number

 



 

 

 

Note: Postcode is essential as it will expedite search inquiries.  It is important that Heroes of Australia #Homesites is able to contact applicants; therefore, a full postal address for delivery of notices must be provided at time of application. High risk personnel can provide department, post, unit or other acceptable in-service address for service of notices.

 

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Postal Address

Postcode

 


 

 

In the interest of preserving your privacy and to help prevent misuse, Heroes of Australia logs the IP addresses of all persons submitting applications and Design and Copy information.   

 

 

 

 

 

 

 

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Declaration by the applicant:

• I declare that the information I have supplied in this form is complete, truthful and correct in every detail
• I acknowledge that I electronically signed my application by placing a check mark the box after “Signature of Applicant”
    

By ticking the box you warrant that you have read and agree with the Terms and Conditions (found here), the Terms of Use and that you are the person so named and authorised to make this application.


 

 

 

 

 

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WARNING: It is an offense under State and Commonwealth Criminal Codes of Australia to deliberately make, or cause to make, a false or misleading statement, or conceal circumstances where there is an intent to committ a crimnial offense: Impersonate another.
 

 

 

 

And further that you authorise Heroes of Australia to use any supplied video, photographic image or sound recording produced in any format (collectively a“Images”) that may be submitted to Heroes of Australia for publication and that you do further acknowledge and agree that you are legally liable for the ownership of all intellectual property and proprietorship of ALL the material content you submit to Heroes of Australia in conjunction with this application, including but not limited to: Text Copy, Photographs, Graphics and Video; whether submitted in digital formats, hard-copy or as hyper-links; e.g., Youtube.com

USER CONDUCT

As a condition of use, you promise not to use Heroes of Australia Services for any purpose that is unlawful or prohibited by the following Terms of Use, or any other purpose not reasonably intended by Heroes of Australia as detailed in Heroes of Australia Disclaimer and Rules of Use.

By way of example, and not as a limitation, you agree not to use the Services:

  • to  abuse, harass, threaten, impersonate or intimidate;
  • to post or transmit, or cause to be posted or transmitted, any Content that is infringing, libellous, defamatory, obscene, pornographic, abusive, offensive, profane, or otherwise violates any law or right of any third party;
  • for any illegal or unauthorized purpose.
  • to create or submit unwanted email ("Spam") to any other Heroes of Australia users or any URL;
  • attempt to impersonate another person;

Heroes of Australia may remove any content and Heroes of Australia accounts at any time for any reason including, but not limited to, upon receipt of claims or allegations from third parties or authorities relating to such Content, or for no reason at all. To report Terms of Use abuse, please email: help@heroz.com.au

You are solely responsible for your interactions with other users of the Site.  Heroes of Australia reserves the right, but has no obligation to monitor disputes between you and other users.

 

 

As Heroes of Australia is designed to showcase the best and most deserving Australians and to preserve their memories as anecdotes written in the first person for future generations to reflect upon it is imperative that those represented in the Hall of Fame are the persons so identified.   Any person found to be attempting to impersonate another, if for malicious purposes the matter will be reported to the Police view criminal charges. Conversely, given Aussie’s penchant for mischievousness, we must ask the scalawags to refrain from using Heroes of Australia for fun and games, and instead perhaps participate themselves by submitting their own profile, wherein they can parade their best gags and other exploits.