Australian Academy of Science

2019Honorific Awards for scientific excellence

NANCY MILLIS MEDAL FOR WOMEN IN SCIENCE

NOMINATION FORM

The Nancy Millis Medal is awarded to female Mid-career researchers in any branch of thenatural sciences. Recipients will have established an independent research program anddemonstrated exceptional leadership.

Award criteria

  • Women researchers in all branches of the natural sciences eight to fifteen years post PhD (or equivalent first higher degree e.g. D.Phil., D. Psych., D.Sc.) in the calendar year of nomination, except in the case of significant career interruptions.
  • Restricted to candidates who are normally resident in Australia and is for research conducted mainly in Australia.

To assist you in filling out this form, please see theGuide for Nominators.

1.Full name, professional position and address of candidate:

Telephone:

E-mail:

Nationality/ies:

Date of birth:

Gender:

Male Prefer not to state 

Female Other:……………………

Australian Residency status:

2.Name and address of nominator(s):

Telephone:E-mail:

3.Non-Technical Description of the Work (Around 150 words)

4.Brief citation (1 page)(see Guide for Nominators for further information):

5.Essential documentation(please tick to indicate documentation provided)(see Guide):

5.1Candidate's detailed curriculum vitae

5.2List of 20 of the candidate’s publications relevant to the award

5.3(If applicable) Early-Mid Career award – eligibility extension request

6.Signature of nominator(s)

Date:

NB:if other nominators wish to endorse this nomination, please do so by email if not available to sign this form.

7.Referee reports(see Guide for Nominators):

(Please attach referee reports at the end of the nomination or have referees submit this directly to by the referee report deadline, informing you when they have done so. Please note that nominations are not complete until these references have been received and it is up to the nominator to ensure that all documentation has been received by the deadline).

8.Lodgingthe nomination form

Send this nomination form to:

Australian Academy of Science Awards

E-mail:

Mail:GPO Box 783, CANBERRA ACT 2601

An electronic copysent by e-mail is preferred. Receipt of the nomination will be acknowledged.

The Award recipient will be announced in early November. For more information about the nomination process, contact the Grants Administration Officer, at call + 61 (0)2 6201 9412.

9.Please help us by stating where you heard of this award round.

Closing date for nominations: 9:00am (AEST) 1 May 2018

Closing date for referee reports: 9:00am (AEST)1 June 2018

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Privacy statement

The Australian Academy of Science (the Academy) is an ‘agency’ for the purposes of the Privacy Act 1988 (Cth) and as such complies with the obligations of the Privacy Act within that meaning. The Academy strives to achieve diversity and equity of participants in the activities that it undertakes, and as such, it monitors the effectiveness of its activities by collecting gender, age and nationality information related to participants of the Award programs.

The Academy acknowledges the complex nature of gender identity and diversity in the broadest meaning.

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