2023 Distinguished Leadership Award nomination form

This Award recognises outstanding contributions by senior executive leaders with a career history of contributions over approximately 10-15+ years.

Nominee's details

Nominee's title Nominee's title

Nominee's first name *

Nominee's last name

Nominee's position title *

Nominee's organisation *

Nominee's email address *

Nominee's contact phone number *

Mobile number preferred

Nominator's details

Nominator's title Nominator's title

Nominator's first name *

Nominator's last name *

Nominator's organisation *

Nominator's email *

Nominator's contact phone number *

Nomination details

Please describe how the nominee meets each of the following criteria. Responses should be no longer than 250 words. Where possible, provide examples to support your statements.

What is the impact that this leader has had during their time in the industry? What success have they achieved and what difference has it made? *

Max. 250 words

What is it about this person that makes them an outstanding leader able to have impact for the industry? How do they make a difference? *

Max. 250 words

Nominee's two-page CV *

Maximum file size: 516MB

Is there anything further that you would like to add to support your nomination? (optional)

You can upload any additional supporting documentation here (optional)

Maximum file size: 516MB

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BioMelbourne Network respectfully acknowledges the Traditional Custodians of the unceded lands and waters of Victoria: the Bunurong, Gunaikurnai and Wurundjeri peoples, on which the BioMelbourne Network and our Victorian members work, and as well as the lands and waters of our members further afield. We pay respect to their Elders past and present. As Australia’s first scientists, we acknowledge the significant contribution that they and other Aboriginal and Torres Strait Islander people have made and continue to make to the research and knowledge systems that inform our community and our sector.

We acknowledge that Aboriginal and Torres Strait Islander people continue to live in a spiritual and sacred relationship with this country and recognise our responsibility to continue to work towards reconciliation.