ALUMNI AND EVENTS OFFICE
THE ALUMNI COUNCIL
2013 ALUMNI AWARDS PROGRAM
NOMINATION FORM
Please ensure you review the submission guidelines before completing this form – further information about the
Alumni Awards, including guidelines, can be found at sydney.edu.au/alumni/awards.
We encourage you to submit supporting documentation with your nomination. All nominations and supporting
statements are confidential.
Only alumni (graduates of the University of Sydney), or University of Sydney students who have met their
degree requirements may be nominated.
ABOUT YOU
Title:
_
_ First
(Prof, Dr, Mrs etc)
name: ____________________ Last name:
____________
Address:
________________
________________
State:
_________
Postcode: ___________________ Phone: _________________
Email address: __________________________________________________________________
Address type:  Home
 Work
Graduation details:
(If applicable, list University of Sydney degree/s and graduation year or expected completion date)
TELL US ABOUT YOUR NOMINEE
Title:
_
_ First
(Prof, Dr, Mrs etc)
name: ____________________ Last name:
____________
Address:
________________
________________
State:
_________
Postcode: ___________________ Phone: _________________
Email address: __________________________________________________________________
Address type:  Home
 Work
Graduation details:
(if applicable, list University of Sydney degree/s and graduation year or expected completion date)
Professional details:
Organisation:
Graduation details:
________
________________
Position:
______________
_____________
(If applicable, list University of Sydney degree/s and graduation year or expected completion date)
NOMINATION FOR AWARD CATEGORY
Achievement Awards (please select only one category)
Closing Date for Nominations 5pm Friday 26 April 2013

Alumni Award for Community Achievement

Alumni Award for International Achievement

Alumni Award for Professional Achievement

Young Alumni Award for Achievement
Graduate Medals (please select only one category)
Closing Date for Nominations 5pm Friday 24 May 2013
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Convocation Medal (undergraduate achievement)
Edmund Barton Medal (masters by coursework achievement)
Rita and John Cornforth Medal (PhD achievement)
Nigel C Barker Medal (sporting achievement)
Sister Alison Bush Medal (Indigenous achievement)
John Harsanyi Medal (international student achievement)
CHECKLIST
For the nomination, I have included:




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A statement outlining why your nominee is worthy of an Alumni Award. (Suggested word
length 500 words). You should read the submission guidelines for the relevant award or medal
available at sydney.edu.au/alumni/awards.
Supporting documentation for these awards should include why you think your nominee is a
worthy candidate.
Additional supporting letters from employers, distinguished alumni and members of the public,
academic supervisors and other senior University staff are encouraged. Please note a
maximum of four additional supporting letters will be accepted.
If available, documentary evidence such as newspaper clippings, copies of certificates, etc of
your nominee's achievements and activities
A curriculum vitae where available should also be included
Please send nominations and supporting statements to:
Awards Coordinator
Alumni and Events Office
Room 204A, Old Teachers College (A22)
The University of Sydney NSW 2006 Australia
T +61 2 9036 7537
F +61 2 9351 6868
E alumni.office@sydney.edu.au
Alumni and Events office
+61 2 9036 7537
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