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2009 Tasmania Awards for Planning Excellence Nomination FormAPPLICANTS DETAILS
Name of ApplicantName of FirmAddressSuburb / CityStatePostcodePhoneMobileEmailIs the Applicant the sole author of the entry?
If not, the applicant must provide details of all partner organisations on separate form. FORMCHECKBOX Yes FORMCHECKBOX NoThe project team (in full) and the client are fully aware the application is being made FORMCHECKBOX Yes FORMCHECKBOX NoIs the Applicant a member of PIA? FORMCHECKBOX Yes FORMCHECKBOX No
PROJECT DETAILS
Title of ProjectAward Category EnteredLead AgencyName to appear on certificate (Additional / Client certificate list on separate piece of paper if required)
AddressSuburb / CityStatePostcodePhoneMobileEmail
Intellectual property conditions governing nomination
No nomination for Awards for planning excellence will be effective unless the copyright and moral right requirements (IP) of the awards program are fully satisfied.
There may be IP implications in both the nominated project (Nominated Project) and in the materials that accompany the nomination (descriptive materials).
You must grant us (or procure) the rights in the IP or both the Nominated Project and in the Descriptive Materials, that are required to allow us to select, edit and reproduce the works for the purposes of the Awards for Planning Excellence.
To do this, in respect of both the Nominated Project and the Descriptive Materials, you must either:
(a) Own the necessary IP and give us the permission we require, or
(b) Obtain a licence or consent from the owner(s) of the IP to use the IP for the purposes of the Awards Program, or
(c) Provide sufficient information for the IP owner(s) to be located and the permission obtained.
(d) You must promise that you have the rights you say you have.
(e) In this respect you must indemnify the PIA for any costs or expenses whatsoever that result from any proven third party adverse claim.
A nomination will not be considered unless the required permission and indemnity is given by the owner or licensee of the IP in:
(a) What is being nominated, and
(b) The Descriptive Materials.
You must complete the Awards for Planning Excellence Copyright and Moral Rights Notification form.
If you do not know the identity of the owner of the IP, the fate of the nomination will depend on the PIAs success in obtaining the permission and indemnity. We can only make reasonable efforts to obtain these.
PROJECT TEAM (for acknowledgement)
The person or company making this nomination for the award is responsible for ensuring the correct attributions of the parties involved. PIA takes no responsibility for any parties omitted from the entry.
PARTNER ORGANISATION 1
Name of FirmContactAddressSuburb / CityStatePostcodePhoneMobileEmail
PARTNER ORGANISATION 2
Name of FirmContactAddressSuburb / CityStatePostcodePhoneMobileEmail
PARTNER ORGANISATION 3
Name of FirmContactAddressSuburb / CityStatePostcodePhoneMobileEmail
PARTNER ORGANISATION 4
Name of FirmContactAddressSuburb / CityStatePostcodePhoneMobileEmail
COPYRIGHT AND MORAL RIGHTS NOTIFICATION
Part 1 Nominated ProjectPart 2 Descriptive Material1.I am the copyright owner of the Nominated Project
FORMCHECKBOX Yes
FORMCHECKBOX No
If yes, go to Question 45.I am the copyright owner of the Descriptive Material (including written, graphic, photographic, drawings, etc)
FORMCHECKBOX Yes FORMCHECKBOX No
If yes, go to Question 82.If you are not the copyright owner of the Nominated Project, are you a licensee?
FORMCHECKBOX Yes FORMCHECKBOX No
If yes, go to Question 46.If you are not the copyright owner of the Descriptive Material, are you a licensee?
FORMCHECKBOX Yes FORMCHECKBOX No
If yes, go to Question 83.If you are not the owner of the copyright in the Nominated Project and not a licensee, who is? Please provide details of the copyright owner:7.If you are not the copyright owner or a licensee of the Descriptive Material, who is? Please provide details of the copyright owner:4.Please select one of the following that applies to you:8.Please select one of the following that applies to you:a.I am the moral rights owner of the Nominated Project and I consent to my work being reproduced, exhibited, published, communicated and/or adapted by the PIA for the purposes of the Awards for Planning Excellence and authorship will be attributed to me.
FORMCHECKBOX Yes, this applies to me.a.I am the moral rights owner of the Descriptive Material and I consent to my work being reproduced, exhibited, published, communicated and/or adapted by the PIA for the purposes of the Awards for Planning Excellence and authorship will be attributed to me.
FORMCHECKBOX Yes, this applies to me.b.I have the written consent from the true author of the Nominated Project (attached) who agrees to their project being reproduced, exhibited, published, communicated and/or adapted for the PIA for the purposes of the Awards for Planning Excellence and authorship will be attributed to the true author.
FORMCHECKBOX Yes, this applies to me.b.I have the written consent from the true author of the Descriptive Material (attached) who agrees to their project being reproduced, exhibited, published, communicated and/or adapted for the PIA for the purposes of the Awards for Planning Excellence and authorship will be attributed to the true author.
FORMCHECKBOX Yes, this applies to me.c.I am not the moral rights owner and I do not have consent from the true author in making this nomination
FORMCHECKBOX Yes, this applies to me.
Who is? Please provide details of author:c.I am not the moral rights owner and I do not have consent from the true author in making this nomination
FORMCHECKBOX Yes, this applies to me.
Who is? Please provide details of author:
SIGN
The statements I have made above are true and correct. I declare to indemnify the Planning Institute Australia (PIA) in any event that I have made false, misleading and/or deceptive statements and agree to pay PIA, jointly or severally, any damages and / or legal costs that may arise from my false, misleading and / or deceptive statements.
SignedDatedPrint Name
SUBMITTED MATERIALS
Please indicate the materials included with your entry:
FORMCHECKBOX Completed nomination form
FORMCHECKBOX Completed Part 1 of Copyright and Moral Rights Notification (if required)
FORMCHECKBOX Completed Part 2 of Copyright and Moral Rights Notification
FORMCHECKBOX Attached CD with required number of images
FORMCHECKBOX A1 display laminated sheets (portrait only, matt finish)
FORMCHECKBOX Required number of hard copies of your project
FORMCHECKBOX Additional Written material as required
Please note:
Materials included with your submission may not be returned as they are kept for exhibition purposes
Please ensure that you keep a copy of this entry form and all graphic and written material included.
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