WALK OF FAME AWARDS
 
 
 
Nominee Details

Only one alumnus can be nominated in this form. Please provide the details below for the alumnus you would like to nominate for the Walk of Fame.

 
Title
 
 
 
 
First Name*
 
 
Last Name*
 
 
Maiden Name (if applicable)
 
 
Street Address 1*
 
 
 
Street Address 2
 
 
 
City*
 
 
State/Province*
 
 
Zip/Postal Code*
 
 
Country
 
 
 
 
Email*
 
 
Mobile Phone*
 
 
Year of Graduation *
 
 
 
Job Title*
 
 
 
Organisation*
 
 
 
 
 
 
Nominator Details

Please provide your details below to enable the Alumni Team to contact you for more information on your nomination.

 
Title
 
 
 
 
First Name 2*
 
 
Last Name 2*
 
 
Maiden Name (if applicable)
 
 
Street Address*
 
 
 
Street Address 2
 
 
 
City*
 
 
State/Province:*
 
 
ZIP/Postcode*
 
 
Country
 
 
 
 
Email*
 
 
Phone*
 
 
Relationship to Nominee*
 
 
 
 
 
 
File Upload*
 
 
 
 
Please provide the following supporting detail:
  • Provide a current professional résumé/biography if possible
  • Provide a written statement (maximum 500 words) detailing why the nominee deserves to be recognised and how they meet the criteria for the award
  • Nominations may also include supporting evidence: awards, media clippings, electronic media footage, etc. (maximum of three attachments)