Honorary Awards Nomination Form
Honorary Doctorate

Honorary Awards are awarded by the University for the purposes of:

formally and publicly recognising the exceptional or distinguished contribution of an individual to the University, the broader society or a field of academic endeavour;

enhancing the standing and reputation of the University; and

expanding or building on existing relationships.

Honorary Awards are prestigious honours, intended to recognise substantial achievements or contributions by individuals.

An Honorary Doctorate will not normally be awarded to a person who is a serving member of Council, a current member of the University staff, or a serving Federal, State or local government politician (or the international equivalent

Please refer to the Honorary Awards Policy and Honorary Doctorate Procedures for further information regarding this Honorary Award and to assist with completing the nomination form.

Criteria for Awards

The criteria for each of the awards are:

Honorary Doctor of Arts	Distinguished contribution to an academic discipline or field of endeavor relating to the creative arts.
Honorary Doctor of Commerce	Distinguished contribution to an academic discipline or field of endeavor relating to commerce and business.
Honorary Doctor of Engineering	Distinguished contribution to an academic discipline or field of endeavor relating to engineering.
Honorary Doctor of Laws	Distinguished contribution to an academic discipline or field of endeavor relating to law.
Honorary Doctor of Letters	Distinguished contribution to an academic discipline or field of endeavor relating to the humanities and social sciences.
Honorary Doctor of Medicine	Distinguished contribution to an academic discipline or field of endeavor relating to medicine.
Honorary Doctor of Science	Distinguished contribution to an academic discipline or field of endeavor relating to the physical sciences or health sciences.
Honorary Doctor of the University	Exceptional service to the University, usually over a sustained period of time.

AND – for all awards:

Exceptional record of service to professional and/or public life.

Please contact the Secretariat via email: secretariat@curtin.edu.au for assistance with completing an Honorary Award Nomination.

1.	Award

Honorary Doctor of Arts	HonDArts (Curtin)	☐
Honorary Doctor of Commerce	HonDComm (Curtin)	☐
Honorary Doctor of Engineering	HonDEng (Curtin)	☐
Honorary Doctor of Laws	HonDLaws (Curtin)	☐
Honorary Doctor of Letters	HonDLitt (Curtin)	☐
Honorary Doctor of Medicine	HonDMed (Curtin)	☐
Honorary Doctor of Science	HonDSc (Curtin)	☐
Honorary Doctor of the University	HonDUniv (Curtin)	☐

2.	Nominee details

Nominations will at all stages be treated confidentially. A nominee must not be advised of, or consulted about, their nomination at any stage.

Title and name
Occupation/Profession
Postal address
Phone
Email address

3.	Statements supporting the nomination, including eligibility criteria

Please indicate how the nominee demonstrates distinguished contribution to their academic discipline or field of endeavour OR (for the Honorary Doctor of the University) exceptional service to the University. (maximum 200 words)

Please indicate how the nominee demonstrates an exceptional record of service to professional or public life or within the wider community. (maximum 200 words)

Please outline the nominee’s contribution and/or relationship to Curtin. (maximum 100 words)

4.	Summary and proposed inscription

Please provide a summary of the claims against the criteria for the award. This will inform the citation to be read out at the time of presentation of the honorary award. (maximum 300 words)

Please provide the inscription to be printed on the award certificate. It reflects the rationale for the honorary award. (maximum 28 words)

5.	Curriculum Vitae and Referees

Curriculum Vitae or Summary Profile/Biography

Please attach a succinct and contextualised summary, and/or an abridged version of the curriculum vitae of the nominee's qualifications, employment history, career highlights, university and community service contributions, significant other awards received, and (where appropriate) publications and other scholarly or professional achievements.

(Maximum 10 pages)

Referees

Please provide two referees who may be contacted regarding the nominee and this nomination as part of the due diligence process. Referee reports can also be provided with the nomination.

Both referees should be external to Curtin.

Referee 1	Referee 2
Title and name
Occupation/Profession
Phone
Email address

6.	Nominator Details and Certification

Council members and staff of the University may provide nominations for Honorary Doctorates:

Nominations made by a member of Council, the Vice-Chancellor or an Executive Manager* may be submitted directly to the Council Secretary;

Nominations made by other members of staff must be submitted to the Council Secretary through their Executive Manager*

(* Deputy Vice-Chancellor/Pro Vice-Chancellor/Vice-President/Chief Financial Officer/Chief Strategy and Marketing Officer/Chief Operating Officer/Chief People Officer/Chief Advancement Officer/Chief Legal Officer)

Name of Nominator
Position Title
Phone
Email address
Length of time the nominator has known the nominee
Nature of relationship the nominator has with the nominee

I certify that the information provided on this nomination form is accurate, and to my knowledge, the nominee is of good fame, integrity and character and demonstrates Curtin’s Values.

Signature of Nominator
Date