Honorary Awards Nomination Form

Title of John Curtin Distinguished Professor

Title of John Curtin Distinguished Visiting Professor

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.

Please refer to the Honorary Awards Policy and the Award of the titles of John Curtin Distinguished Professor and John Curtin Distinguished Visiting Professor Procedures for further information regarding this Honorary Award and to assist with completing the nomination form.

The duration of the Honorary Award Title is five (5) years or until retirement, resignation or the appointment to the University concludes by the Professor, whichever comes first. The Honorary Award title may be awarded for consecutive periods.

Criteria for Awards

John Curtin Distinguished Professor
The criteria for the award of the title ‘John Curtin Distinguished Professor’ are that the nominee:

holds the title of Professor at Curtin University (which includes global campuses); and

has the demonstrated capacity to provide a significant and sustained contribution to the University, as evidenced by:

distinguished national or international academic reputation; and

exceptional teaching and/or research skills; or exceptional scholarly, creative and artistic achievements; and

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

John Curtin Distinguished Visiting Professor
The criteria for the award of the title ‘John Curtin Distinguished Visiting Professor’ are that the nominee:

is a Visiting Professor of the University (including global campuses); and

has the demonstrated capacity to provide a significant and sustained contribution to the University, as evidenced by:

distinguished national or international academic reputation; and

exceptional teaching and/or research skills; or exceptional scholarly, creative and artistic achievements; and

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

Please contact the Secretariat on Email: secretariat@curtin.edu.au for assistance with completing this Honorary Award Nomination.

Award

John Curtin Distinguished Professor Nominee is a current member of staff of Curtin University who holds the title ‘Professor’ at level E.	☐
John Curtin Distinguished Professor – Renewal of award Nominee currently holds the title ‘John Curtin Distinguished Professor’	☐
John Curtin Distinguished Visiting Professor Nominee is currently appointed to Curtin University as a ‘Visiting Professor’	☐
John Curtin Distinguished Visiting Professor – Renewal of award Nominee currently holds the title ‘John Curtin Distinguished Visiting Professor’	☐

Nominee details

Nominations will at all stages be treated confidentially. A nominator may, however, advise a nominee of their nomination, to enable them to provide information to support the nomination. The nominator must, however, advise the nominee that a nomination does not guarantee that the title will be awarded.

Title
First name
Last Name
Faculty or Area
Contact phone number/s
Email address

Statements supporting the nomination, including eligibility criteria

For a renewal nomination, the Committee will consider the nominee’s track record over the preceding five years and the level of sustained contribution since the award was conferred or last renewed.

Please provide clear and detailed information justifying the nomination, that describes how the nominee has the demonstrated capacity to provide a significant and sustained contribution to the University, as evidenced by:
Distinguished national or international academic reputation (maximum 500 words)

Exceptional teaching and/or research skills; or exceptional scholarly, creative and artistic achievements (maximum 500 words)

Distinguished record of service to professional and/or public life (maximum 500 words)

Please provide an outline of the nominee’s research or teaching plan for the five-year award period. (maximum 500 words)

Corporate Communications

Please provide a summary of the nominee’s distinguished service and commitment to the University or the rationale for the nomination for the award. This information will be provided to Corporate Relations to be used for media releases and news stories (both internal and external). (maximum 100 words)

Curriculum Vitae and Referees

Curriculum Vitae or Summary Profile/Biography

Please attach a succinct and contextualised summary, as well as 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)

CV or Summary Profile Attached	☐

Referees

Please provide two (2) referees who can be contacted regarding the nominee and this nomination as part of the initial due diligence process. Referee reports can be provided with nomination, where available. Both referees should be external to Curtin.

Referee 1	Referee 2
Title
First name
Last name
Occupation/Profession
Contact phone number/s
Email address

Nominator Details and Certification

Please refer to Section 2.1.5 of the Award of the titles of John Curtin Distinguished Professor and John Curtin Distinguished Visiting Professor Procedures.

Where a nomination is made by a Pro Vice-Chancellor:

a)	the nominee must be associated with that Pro Vice-Chancellor’s Faculty; and

b)	the Pro Vice-Chancellor will:

i)	convene a small Faculty group including the Pro Vice-Chancellor, Dean Research and Development (or equivalent) and one Head of School (or equivalent) to select the best possible candidate(s) from that Faculty; and

ii)	provide a written assurance that they consider that the nominee(s) is the best candidate from the relevant Faculty for that specific title.

Please list the members of the Faculty Group convened to consider potential candidates for this Honorary Award Title:

Title	Name	Position

Only the Vice-Chancellor and Executive Managers* may provide nominations for the Titles of John Curtin Distinguished Professor and John Curtin Distinguished Visiting Professor.

(*Deputy Vice-Chancellor/Pro Vice-Chancellor/Vice-President/Provost/Chief Financial Officer/Chief Strategy Officer/Chief Operating Officer/Chief Legal Officer).

Name of Nominator
Position Title
Contact phone number/s
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