Nomination Form

University of Adelaide 2021 Distinguished Alumni Awards.

Nominations close Monday 15 June 2021.  

Self-nominations will not be accepted.

Please identify for which award you are nominating (select one)

Recognises the outstanding and sustained contributions made by University of Adelaide alumni in their local communities and beyond.

Recognises both Aboriginal and Torres Strait Islander and non-Aboriginal alumni whose significant achievements have impacted their profession and/or community.

Recognises young alumni (35 years or younger at the nomination deadline) who are making a significant contribution as emerging leaders within their profession and/or within their community.


(the alumna/alumnus you wish to nominate)


(your details)

Relationship to the University

Selection criteria

In 300-500 words, describe the qualities of the nominee against the following criteria. You are welcome to attach support documents to this nomination.

(a) Demonstrates sustained and significant contributions in one or more of the following areas: Humanitarian, Professional Excellence and/or Outstanding Community Service.

(b) Professional or volunteer work, demonstrates a significant positive impact that has been recognised by peers –locally, nationally and/or internationally.

(c) Through prominence in their field or profession, brings great distinction to the University of Adelaide.

(d) Demonstrates leadership qualities in a variety of contexts, such as volunteering, or community and professional work.

Maximum 3 files.
20 MB limit.
Allowed types: gif jpg png bmp pdf doc docx .

How did you hear about the Distinguished Alumni Awards?

Please note the University of Adelaide will contact you, the nominator, to request more information and referees should the nominee be shortlisted.