Alumni awards nomination form Your details (nominator)Given name * Family name * Email address * Mobile phone * Relationship to nominee * Company or organisation name Position at company or organisation Award nomination categoryPlease select the award for which you are submitting a nomination. * Distinguished Alumni Award (DAA) - For significant personal and professional accomplishments or service to the community, state, or nation. Young Achiever Award (YAA) - For alumni 35 years or younger who are early career achievers. Chancellor’s Award - For exceptional circumstances where traditional categories are not suitable, such as for a group of alumni. Award nominee's detailsGiven name * Family name * Preferred name Name at graduation (If different to above). Email address * Organisation name Position in organisation Submission requirementsDescribe the nominee's achievements, impact, and contributions based on the award criteria. Please include any current or ongoing connection with La Trobe. * Please keep your written submission to a maximum of 1000 words based on selection criteria. Please provide the nominee's LinkedIn profile URL (if applicable). Please provide any other supporting documentation you have available (nominee CV, reference list, past awards). Accepted file types: .doc, .docx, .pdf, .jpg, or .png. Maximum: 6 pages, 8MB file size. Referee Information A referee is required to endorse the nomination and must be different from the nominator. Referee 1 detailsGiven name * Family name * Email address * Mobile phone Relationship to nominee Company or organisation name Position at company or organisation Referee 2 detailsGiven name Family name Email address Mobile phone Relationship to nominee Company or organisation name Position at company or organisation Confidentiality All information provided will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. Information collected will only be used to select and shortlist Distinguished Alumni and Young Achiever Award recipients. In accordance with privacy laws, personal information about you contained in your enquiry will not be used for any other purpose. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the Alumni and Advancement Office via email at alumni@latrobe.edu.au. Validation
