Applicant's contact details:

Name (required)

Position: (required)

Phone (required)

Email (required)

Applicants are to complete the following questions in the specific word length. Dot points are acceptable.

What Community Engagement have you been involved with that is not part of your course work or part of any paid employment at the University or elsewhere? (required)
(Up to 200 words)

What were the outcomes of your Community Engagement involvement? (required)
(Up to 200 words)

Provide a personal statement on the Community Engagement you have done and what you have learnt about yourself and the people you have been engaged with in your Community Engagement activities. (required)
(Up to 250 words)

We nominate for the Student Award for Outstanding Community Engagement. The reasons for nominating this person for the Award are attached.(required)

Nominations must be made by two persons, at least one of whom is a staff member, and the nomination must be accepted by the Nominee, as indicated below.

Nominator 1:

Name (required)

Position (required)

Phone (required)

Email (required)

Nominator 2:

Name (required)

Position (required)

Phone (required)

Email (required)

PLEASE NOTE: The Nomination must include a supporting statement from the organisation in which the Nominee has been involved in community engagement.

Supporting statement from the organisation in which the Nominee has been involved (required)

The maximum file size you can upload is 2MB

Completed forms will be forwarded to Melinda Scott
Tel: (07) 3623 7234
Fax: (07) 3623 7149
Email: Melinda.Scott@acu.edu.au