Nomination Form for Alumni Awards

Nominations have now closed for 2018.

Note: Nominations for the Aboriginal and/or Torres Strait Islander Community Impact Award have been extended. The deadline for submissions for this award only is 29 June 2018.

A judging panel including the Chancellor will convene in August and up to three finalists will be selected in each category, and one winner. Please contact the Alumni team at alumniawards@westernsydney.edu.au.

Nominations will be open from 3 April - 3 June 2018 and only submissions received during this period of time will be considered.To nominate, please complete the form below in full, including the required attachments, addressing the relevant selection criteria.

Detailed criteria for each Award category is outlined in the 2018 Nominations Brochure (PDF, 1113.18 KB)(opens in a new window).

Detailed information on eligibility and conditions of entry are available in the 2018 Nominations Brochure (PDF, 1113.18 KB)(opens in a new window), pages 9-10.

Fields marked with an asterisk (*) are required. If you have any problems accessing this form, please contact alumniawards@westernsydney.edu.au.


Your email address as nominee or nominator, i.e the individual submitting this form.
Nominee/Nominator*

Step 1: Nominee’s personal and contact details


Including number, street name, suburb, state and postcode.

Type your birthday in this format DD/MM/YYYY

Step 2: Nominee’s Professional Details

Step 3: Nominator's Contact Details (if different to nominee) Skip this step if self-nominating.


Not required if self-nominating

Not required if self-nominatingNot required if self-nominating

Including number, street name, suburb, state and postcode.Not required if self-nominating

Not required if self-nominating

Not required if self-nominating

Not required if self-nominating
If nominator is a graduate of Western Sydney University, please tick box and provide Student ID number

Step 4: Selection of Awards

Please select the award(s) you are nominating for:
Note: The Chancellor’s Alumni Leadership Award is the highest honour the Alumni Awards can bestow. This award is not open for application but will be decided at the discretion of the Awards Judging Panel considering nominations for all other award categories.

Step 5: Statement of Application*


In a written statement (maximum 1,000 words), please address the criteria as outlined for each award and provide detail on why the Nominee deserves to be recognised.
If you are applying for more than one award category, please address each category in a separate statement that clearly outlines the relevant award category with headings. (The  file upload limit for this step is 5MB, Text PDF, doc, docx files are accepted.)

Step 6: Curriculum Vitae and other relevant documents


Please ensure this contains academic qualifications (including qualifications awarded to the Nominee by other educational institutions) and the Nominee’s career since graduation. (The combined total file upload limit for this step is 5MB. Pdf, doc, docx files are accepted.)

Nominee should attach a recent photograph as a png, jpg, .jpeg file of no more than 5MB.

Supporting evidence (for example, awards, media clippings, electronic media footage, etc.)


(The combined total file upload limit for this step is 5MB. Pdf, doc, docx files are accepted.)

Referee 1

Is Referee 1 a graduate of Western Sydney University?

If 'yes' was ticked in response to the question above.

Referee 2

Is Referee 2 a graduate of Western Sydney University?

If 'yes' was ticked in response to the question above.

Declaration*

I am nominating myself and/or have permission from the Nominee to submit this application*
Ticking the box confirms that you are self-nominating, or have permission from the Nominee to submit this application for the Western Sydney University Alumni Awards and Alumni staff can contact Nominee directly upon submission.All information included is correct and accurate to the best of my knowledge.



Pages may take several minutes to load after clicking the submit button. Please await the confirmation screen to ensure that your nomination has been accepted before closing your browser. You will also receive a confirmation email shortly after submission.