Zonta New Zealand Woman of the Biennium 2017

Confidential Nomination Form

This form is to be used by Zonta Clubs in District 16 when nominating a candidate for the Zonta New Zealand Woman of the Biennium Award 2017.

The aim of this Award is to recognise a woman in New Zealand who has made an outstanding contribution in any field and is a role model for others. This Award may be sponsored, but is not expected to include a monetary value. A gift or trophy may be provided at the discretion of the Governor.

All nominees must be New Zealand citizens or permanent residents.

The criteria and assessment process for the Award is contained on page 4 of this form.

The successful nominee will hold the title of ‘Zonta New Zealand Woman of the Biennium 2017’

The Award will be presented at the District Conference to be held on the 22nd -24th September 2017.

All nominations must be treated in confidence.Do not tell the person nominated, until the nomination process has been completed.

Nomination forms must be signed by the Club President, and seconded by another Club Officer. Please forward this form, together with 2 referees’ statements, to the Governor by 5pm, 26th June 2017.

Address for mailing:

Zonta New ZealandWoman of the Biennium Award

C/- Governor District 16

Janet Hope

40 Kath Hopper Drive

Orewa

Auckland 0931

Nominated by the Zonta Club of…………………………………………………

President:………….……………. Signature:……………………………

Seconded by:………………………. Signature:…………………………….

Details of the Nominee

Nominee’s title (Ms, Mrs, Miss, Dr, Prof) ………………….

Family Name……………………………………………………………….

First Name/s………………………………………………………….…….

Address………………………………………………………………..……

……………………………………………………Postcode…….………..

Telephone; .Home:……….…….. Business:……….…… Mobile:……………

Facsimile:………………………………….Email:…………………………………

Is the nominee a current Member of a Zonta Club in District 16?

If yes, which Zonta Club? ………………………………………………………..

Length of membership? ………………….

Please provide a statement to support this nomination (500 words maximum).

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..….

Additional information may be appended to this application, but should be drawn from publicly available records, and sources of information must be identified.

Details of confidential references in support of this nomination

(1) Referee

Name:…………………………………………………………………………..….

Organisation :…………………………………………………………………....

Position:……………………………………………………………………………

Contact address:……………………………………………………………….…

Phone No. (Business):……………………………………………………………

Letter of recommendation appended? Yes/No. (delete one)

May this reference be released to the nominee? Yes/No (delete one)

(2) Referee

Name:…………………………………………………………………………..….

Organisation ……………………………………………………………………...

Position:……………………………………………………………………………

Contact address:……………………………………………………………….…

Phone No. (Business):……………………………………………………………

Letter of recommendation appended? Yes/No.(delete one)

May this reference be released to the nominee? Yes/No (delete one)

Criteria for Selection of Award recipient

The successful nominee will have:

  1. The highest standards of personal ethics and integrity.
  1. Significant personal contribution to empowering women through leadership, service provision and/or advocacy in any field of endeavour.
  1. Community involvement and/or service
  1. Significant personal achievement in the nominee’s chosen area of profession and/or business.

Selection Process

  1. Nominations must be received by 5pm, 26th June 2017. Late nominations will not be considered.
  2. All nominations must be on the required form, appropriately signed and accompanied by 2 written references.
  3. Governor District 16will convene a Selection Committee of not less than three (3) members. Ideally this should include at least one (1) independent member.
  4. The Selection Committee will review the nominations against the agreed criteria.
  5. The Selection Committee will recommend to the Governor and District 16 Board one (1) preferred candidate and one (1) alternate. If no candidate is considered to meet the criteria of the Award,the Selection Committee may recommend, and the Governorapprove, withholding the Award.
  6. Governor District 16willformally approach the preferred candidate regarding acceptance of the Award by 31 July 2017. If the preferred candidate declines the Award, the alternate will be automatically approached.
  7. The Governor District 16 will confirm the Award in writing to the recipient within 5 working days, together with confirmation that the recipient has agreed tothe use of her name and details for purposes of promoting the Award and the objects of Zonta International.
  8. Presentation of the Award will take place at the 14th biennial Zonta District 16 Conference22nd -24thSeptember 2017. Travel within New Zealand and overnight accommodation costs for the recipient and hosting at the Awards dinner for the recipient and one (1) dinner guest will be provided by District 16.
  9. Award recipients areexpected to be present to receive the Award in person, and to speak briefly after acceptance.
  10. The Award recipient is expected to provide a media statement if requested, to consent to her name and profile being placed upon the District 16 website, following the Award ceremony, and to inclusion in any Zonta International publication.
  11. The Award recipient may be asked by Clubs to speak or undertake duties during the following biennium, and although desirable, this is not obligatory.

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Zonta Woman of the Biennium – Nomination Form – January 2017