Please read this information before you apply

Please complete all sections of this form and attach a copy of the documentary evidence proving the year of birth.

The evidence can be a:

  • Birth Certificate (preferred)
  • Statutory Declaration stating the year of birth
  • copy of a driver’s licence or passport.

Please note that you will not be able to submit the application if this evidence is not attached.

Applications should be submitted no less than two (2) months and no more than six (6) months prior to the date of the birthday. Applications received with less than two (2) months' notice will be processed but cannot be guaranteed to arrive by the date of the birthday.

Applications later than one month after the birthday cannot be submitted.

The Department of the Premier and Cabinet's Protocol Unit processes messages to be sent from the Premier of South Australia. It also advises the offices of Her Majesty The Queen, the Governor-General, the Governor of South Australia, the Prime Minister, Federal and State Leaders of the Opposition, and Federal and State Members of Parliaments for 90th, 95th, 100th, 105th and 110th birthdays.

Please note that messages are not sent from Her Majesty to persons who are not citizens of a Commonwealth country.

The Protocol Unit can only process applications for recipients who are residents of South Australia. Please contact the relevant state or territory Department of the Premier and Cabinet (or equivalent) for recipients residing in other states.​


* = Required information

Milestone Details

Date of Birth *
 
Milestone *
 

Evidence

Evidence of Year of Birth *
* Please choose a file which is 4MB in size or smaller. *