University of Mpumalanga Co-curricula Awards
NOMINATION FORM 2023
How to nominate
1. Societies/Clubs/Teams can nominate individual candidates and /or societies/clubs/teams for the
relevant/respective category.
2. Students can only nominate members of a society/club/residence, CRC/SRC, etc.
3. In a case of more than one nominations, a separate nomination form must be completed.
4. Incomplete forms will not be considered for assessment.
Submit your completed form to:
Office: Student Affairs Offices
Mbombela Campus:
Mrs Lebohang Sithole
Student Development Officer
3rd Floor
Building 10 West Wing,
Email: Lebohang.Sithole@ump.ac.za
Siyabuswa Campus:
Mrs Euphodia Mashego
Ground Floor
Admin Building
Email: Euphodia.Mashego@ump.ac.za
Closing date for nominations
12 October 2023; 16h00
Nominee details (Complete where applicable, i.e. an individual or group nominee)
Individual Nominee
First name:
Nominee student number:
Nominee’s phone number:
Nominee year of study:
Surname:
Nominee’s field of study:
Name of Category:
Campus:
Group
Name:
Campus:
Name of Category:
Supporting documents
When making your nomination, please provide short statements describing how the nominee meets the
identified criteria, as per the attached criteria for the categories. Where possible, provide examples to
support the statements. (Please limit response to space provided, and you may attach supporting
documents to the form).
1. State the criteria:
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2. State the criteria:
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3. State the criteria:
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4. State the criteria:
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5. State the criteria:
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6. State the criteria:
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7. State the criteria:
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8. State the criteria:
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9. State the criteria:
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10. State the criteria:
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Nominated by
Name of the individual/team/society/club
Student or Employee Number
Signature
Date