Sir James Wolfensohn Public Service Scholarship

Nominee Details		Nominator Details
Title		Title
First Name		First Name
Surname		Surname
Position		Position
Organisation		Organisation
Email		Email
Work Phone		Work Phone
Mobile		Mobile
Address A		Address A
Address B		Address B
City/Suburb		City/Suburb
State	Select State ACT NSW NT QLD SA TAS VIC WA	State	Select State ACT NSW NT QLD SA TAS VIC WA
Postcode		Postcode
Nominator Confirmations As nominator, you are required to confirm the following four points. Please select YES to give these following four confirmations.  Yes No 1. The Nominator is the head of a Commonwealth, State or Territory Department, agency or entity. 2. The Nominee is an employee of a Commonwealth, State or Territory Department, agency or entity. 3. The Nominee is a promising senior public servant, expected to play a significant role in the design and implementation of public policy in Australia, possibly as a Department, agency or entity head in the near term. 4. Should the Nominee receive the scholarship, the Nominator will authorize paid study leave for the duration of the executive education program at the Harvard Kennedy School and fully release the Nominee from their duties during that time. Please note that the longest executive education program offered by Harvard Kennedy School runs for three weeks.
As a nominator, you are required to confirm whether you would provide co-funding for point 5. Please select YES or NO to confirm
5. You would provide co-funding support in the event that your Nominee has selected an executive education program of longer than one week  Yes No