Name Bank Nomination Form

Southern Grampians Shire Council is creating a community name bank to help identify suitable names for future roads and public places, with an emphasis on women, First Peoples and underrepresented groups.  

We are seeking nominations of people who have made a significant contribution to our community and whose legacy deserves recognition. 

Please provide as much information as possible. Nominations may be assessed against relevant naming guidelines before inclusion in the Name Bank.