Sir James Wolfensohn Public Service Scholarship
Nomination Form
To be completed by the Nominator
Only the head / most senior executive of a Commonwealth, State or Territory Department, agency or entity can nominate someone for the Sir James Wolfensohn Public Service Scholarship.
After you have completed this nomination form, you will be contacted personally by the Harvard Club of Australia to confirm the nomination.
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Nominee Details |
Nominator Details |
Title
Title Required
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Title
Nominators Title Required
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First Name
First Name Required
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First Name
Nominator's First Name Required
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Surname
Surname Required
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Surname
Nominator's Surname Required
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Position
Position Required
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Position
Nominators Position Required
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Organisation
Organisation Required
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Organisation
Nominators Organisation Required
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Email
Email Required
Invalid Email
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Email
Nominators Email Required
Invalid Nominator Email
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Work
Phone
Work Phone Required
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Work
Phone
Nominator's Work Phone Required
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Mobile
Mobile Required
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Mobile
Nominators Mobile Required
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Address A
Home Address A Required
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Address A
Nominator's Address A Required
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Address B |
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Address B |
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City/Suburb
City/Suburb Required
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City/Suburb
Nominator's City/Suburb Required
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State
State Required
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State
Nominator's State Required
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Postcode
Postcode Required
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Postcode
Nominator's Postcode Required
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Nominator Confirmations
As nominator, you are required to confirm the following four points. Please select YES to give these following four confirmations.
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. |
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As a nominator, you are required to confirm whether you would provide co-funding for point 5. Please select YES or NO to confirm
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5. You would provide co-funding support in the event that your Nominee has selected an executive education program of longer than one week
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