The Western Sydney University Community Fellowship recognises outstanding contributions of individuals to the Western Sydney region.
Fields with '*' are required as mandatory fields and must be filled in.
Nominator Details Nominee Details Selection Criteria *Briefly explain how the nominee has contributed and impacted the social, economic, cultural, environmental and/or technological development of the Western Sydney region: [200 words maximum]
Note: If successful, this statement will be read out at the Graduation Ceremony *Brief biography or CV: (less than 3 pages) Other awards the nominee may have received: Recent media and/or other public recognition: *Reference letter from nominator,including information about how you know the nominee: To the best of your knowledge, has the nominee been convicted of an indictable offence in Australia or an equivalent offence in any other jurisdiction? If Yes, Please provide further information I declare that the information i have entered is true and correct at the time of submission.
If you have trouble using this form please contact Engagement@westernsydney.edu.au
