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Section A
This section is the same for all categories. Only complete it once if multiple category applications are made
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Name, Institute and Date
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Provide a brief summary, in 400 words or less, of your career to date
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What would you like to achieve in the long run in your career? Briefly describe up to three key goals/ambitions you hold for the future.
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In 400 words or less, outline up to three of the MOST significant contribution(s) that you have made to your field to date. If any of these outcomes arose from the work of a team, indicate your particular contribution
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What is the impact of these contributions? Provide a 400 word summary of how these contributions have impacted on the industry, in past, present and/or the future
If relevant provide details of your publications (including conference papers, posters, etc), presentations or industry benchmarks achieved; or any other significant achievements.
Examples might include:
Awards or prizes relevant to your industry that you have received.
Participation in industry and/or professional societies or organisations (including editorial boards, conference organising committees, etc), including role(s) and dates
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The Selection Panel may decide to refer to Referees to assist them with their decision making. References may only be sought for shortlisted candidates.
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If you are shortlisted you will be required to provide a photo for promotional use.
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Section B
This section is relevant to this category only.
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What other actions have you undertaken that demonstrate your commitment to taking a seat in the board room?
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If you could seat on any board, which one would it be and why?
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How would this award enable you to improve your performance in your current role and contribute to your future goals and aspirations?
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