UOWD Alumni Awards - Research, Innovation and Entrepreneurship

Nomination Form - UOWD Alumni Awards: Research, Innovation and Entrepreneurship

Additional pages and relevant supporting documentation may be attached if there is insufficient space on the form.

NOMINEE

Title

(Mrs, Ms, Mr, Dr, Prof etc)

First Name

Surname

Suffix

Address

State

Postcode

Country

Phone

Occupation

UOWD Qualification and Year awarded

Other tertiary qualifications

NOMINATOR

Title

First Name

Suffix

Surname

Address

Suburb

State

Postcode

Country

Phone

Relationship to the nominee

Are you a Graduate of the UOWD

Yes

Other...

(You don’t need to be a graduate in order to nominate

SUPPORTING STATEMENT

Please address selection criteria as outlined below:

Has achieved sustained success throughout their career that is noteworthy and exceptional (500 words)

Demonstrates sustained contribution to their profession, business and/or community at local, national and/or international levels (300 words)

Attach Additional Documents (optional)

One file only.
4 MB limit.
Allowed types: jpg png txt pdf doc docx ppt pptx xls xlsx jar rar tar zip.

Additional pages and relevant supporting documentation may be attached here. Accepted file types

REFEREE DETAILS

Full Name of Referee

Address of Referee

State

Country

Telephone

Are you a graduate of UOWD

Yes

Other...

Relationship to the Nominee

Supporting Statement

Attach Additional Documents (optional)

One file only.
8 MB limit.
Allowed types: jpg png txt pdf doc docx ppt pptx xls xlsx jar rar tar zip.

Additional pages and relevant supporting documentation may be attached here.

SUBMIT NOMINATION

Nominations must be submitted online.

For further information, contact:

Block 14, University of Wollongong in Dubai, Knowledge Park Dubai, UAE. Telephone +971 4 278 1721. Email [email protected]

This information is collected for the purposes of considering nominations for the Alumni Award. The University is committed to protecting your privacy.

CHECKLIST

Contact details of nominee and nominator (compulsory)
Supporting statement addressing selection criteria outlined in the 2015 Alumni Award Guidelines. (compulsory)
Statement (s) from at least one referee to support the nomination who is not the nominator (compulsory)
Nominee’s most recent CV (compulsory)

Optional attachments:

Other documents to support the nomination – eg newspaper articles, statement of awards, etc

PDF versions of the nomination form for planning purposes, along with the guidelines are available at : http://www.uowdubai.ac.ae/alumni-awards-guidelines

Please ensure the following is completed on your Nomination Form:

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