THE TILLYARD PRIZE
2016
NOMINATION FORM
The Tillyard Prize is awarded to the student whose personal qualities and contributions to University life have been outstanding and who has completed, in the current academic year a degree of bachelor with honours (H1 or H2A).
The prize is $1,000 and a formal citation which is presented, where possible, at a Conferring of Awards Ceremony.
It is important to note that, as this prize requires completion of Honours in the year of the award, a student in a combined program may be nominated for the prize before they have completed the second part of their combined degree program.
A nomination may be submitted by:
· Students, through the appropriate Head of Discipline, to Head of School and Dean of College for endorsement, either for themselves or for other suitably qualified students ensuring that there is time for the Recommendation (Section 10) to be completed by the appropriate people and the Nomination forwarded for receipt by the closing date; or by
· Deans of ANU Colleges, Heads of Discipline areas, Schools, Centres, Programs etc or other academic staff of the University.
WHEN THE NOMINATIONS ARE DUE:
Determination of these awards will be made by the University Medals Committee. In order to be considered at the end of year meeting all complete nominations must be received by:
CLOSE OF BUSINESS: 29th NOVEMBER 2016
WHERE THE FORMS ARE DUE:
All endorsed nominations must be sent as a pdf file to . No hard copy or late nominations will be accepted due to tight turnaround times.
QUESTIONS TO BE COMPLETED BY NOMINATOR AND/OR NOMINEE
1. NOMINATION FOR THE TILLYARD PRIZE
Surname: ______
Name:______
Student number: ______
Degree program:______
Honours discipline: ______
2. MEMBERSHIP OF STUDENT ORGANISATIONS
Set out the names of organisations, roles and specify whether these roles are paid or voluntary:
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3 PARTICIPATION IN UNIVERSITY LIFE
3.1 Set out areas of participation within the University, roles and specify whether these roles are paid or voluntary:
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3.2: Set out areas of participation outside the University, roles and specify whether these roles are paid or voluntary:
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4. COMMUNITY INVOLVEMENT
Set out areas of involvement, Roles and specify whether these roles are paid or voluntary:
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5. COMMENTS ON PERSONAL QUALITIES
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6. NAMES OF THREE REFEREES:
NOMINATOR - Please ask the referees to provide written support for the nomination (to be included when submitting the nomination)
Name______
Address______
Phone______Email______
Name of organisation ______
Name______
Address______
Phone______Email______
Name of organisation ______
Name______
Address______
Phone______Email______
Name of organisation ______
7. NOMINATOR
Nominated by: ______
(If you are a student please advise how long you have known the nominee)
Signature: ______
Date: ______
Email contact: ______
8. ACADEMIC HISTORY
To be completed by the Head of a Discipline area, School, Centre, Program, Institute or Dean of the College of Law.
A complete academic record will be made available to the University Medal Committee.
8.1 FINAL HONOURS RESULT (This may be provided immediately before the meeting of the University Medal Committee if not available when the nomination is submitted)
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8.2. COMMENTS ON COMPLETE ACADEMIC RECORD - With particular reference to Honours year and with reference to prizes not shown on academic record, if relevant.
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9. EXAMINERS' REPORTS
The University Medal Committee has asked that Heads of Discipline areas, Schools, Centres, Programs and the Dean of Law submit final Honours Year examiners' reports in full for all nominations for the Tillyard Prize. Please attach relevant documents to this form and ensure that the examiners’ are identified.
10. RECOMMENDATION
To be completed by the Head of discipline area, school, centre, program, institute or Dean of the College of Law
(A separate sheet may be attached if necessary)
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Name: ______
Signature and date:______
Designation and Area, School, Centre, Program, Institute or College:
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The information contained in this document and supporting material will remain confidential to the University Medal Committee.
Enquiries to the Prizes Office:
Ph: 6125 3455
Email enquiries to:
Joan Angel
Acting Registrar, Student Administration
Division of Student Administration
October 2016
ANU CRICOS Provider Number 00120C 6 of 6