Nomination Community Fellows 2020

The Western Sydney University Community Fellowship recognises outstanding contributions of individuals to the Western Sydney region.

Fields with '*' are required as mandatory fields and must be filled in.

*Briefly explain how the nominee has contributed and impacted the social, economic, cultural, environmental and/or technological development of the Western Sydney region: [200 words maximum] Note: If successful, this statement will be read out at the Graduation Ceremony
*Brief biography or CV: (less than 3 pages)
Other awards the nominee may have received:
Recent media and/or other public recognition:
*Reference letter from nominator,including information about how you know the nominee:
To the best of your knowledge, has the nominee been convicted of an indictable offence in Australia or an equivalent offence in any other jurisdiction?	Yes No
If Yes, Please provide further information
I declare that the information i have entered is true and correct at the time of submission.	Yes No

If you have trouble using this form please contact Engagement@westernsydney.edu.au