Research Australia Health and Medical Research Awards | Nomination Form

This will be the 14th annual awards program to be hosted by Research Australia by the sector for the sector. There have been a few minor changes to the program. This year we have selected representatives from Research Australia's Board to join the Awards Subcommittee to review and evaluate all nominations.

We recommend that you review previous award recipients (http://researchaustralia.org/events/hmr-awards/award-winners/) for your category and ensure you address the questions that are included in each category description. Each nomination must not be longer than 700 words per submission and include responses to the questions highlighted. You can nominate an individual, team or organisation.

If you have any questions about the Awards process and program please email awards@researchaustralia.org or call 02 9295 8545.

Please complete all fields below, if it isn't relevant then enter NA.

Question Title

* Nominee

Nominations can be for any individual, team or organisation that meets the criteria for that Award category. Research Australia Membership is not a prerequisite, nor is it of any advantage or disadvantage during the entire nomination process.

Primary Contact Name

Organisation

Address

Address 2

City/Town

State

Postal Code

Email Address

Phone Number

Question Title

* Primary Nominator

Two nominators are required for each nomination. The primary nominator must be a member of Research Australia. A seconder (which may be an individual, team or organisation) is also required; they do not need to be a Research Australia member.

Primary Contact Name

Research Australia Membership Organisation

Address

Address 2

City/Town

State

Postal Code

Email Address

Phone Number

Question Title

* Seconder - Nominator

A seconder (which may be an individual, team or organsiation) is also required; they do not need to be a Research Australia member.

Primary Contact Name

Organisation

Address

Address 2

City/Town

State

Postal Code

Email Address

Phone Number

Question Title

* Award Categories
Please select one category you are nominating your nominee.

Advocacy Award

Data Innovation Award

Great Australian Philanthropy Award

Griffith University Discovery Award

Health Services Research Award

Leadership in Corporate Giving Award

The Peter Wills Medal

Question Title

* NomineeNominations can be for any individual, team or organisation that meets the criteria for that Award category. Research Australia Membership is not a prerequisite, nor is it of any advantage or disadvantage during the entire nomination process.

Question Title

* Primary NominatorTwo nominators are required for each nomination. The primary nominator must be a member of Research Australia. A seconder (which may be an individual, team or organisation) is also required; they do not need to be a Research Australia member.

Question Title

* Seconder - NominatorA seconder (which may be an individual, team or organsiation) is also required; they do not need to be a Research Australia member.

Question Title

* Award CategoriesPlease select one category you are nominating your nominee.

* Nominee

Nominations can be for any individual, team or organisation that meets the criteria for that Award category. Research Australia Membership is not a prerequisite, nor is it of any advantage or disadvantage during the entire nomination process.

* Primary Nominator

Two nominators are required for each nomination. The primary nominator must be a member of Research Australia. A seconder (which may be an individual, team or organisation) is also required; they do not need to be a Research Australia member.

* Seconder - Nominator

A seconder (which may be an individual, team or organsiation) is also required; they do not need to be a Research Australia member.

* Award Categories
Please select one category you are nominating your nominee.