COMMENDATION FOR EXCELLENCE
IN SUPPORT OF THE STUDENT EXPERIENCE

APPLICATION FORM

Please put a cross in (X) one box
Individual application  / Team application 
Nominated Area / Please select one of the following areas of strategic priority
Access, Equity and Participation
 Curriculum Design, Assessment and Feedback
 The Online Experience
 Graduate Destinations
Staff Engagement
Contact details (for nominee, or one representative of a team)
Title
First name
Last name
Email address
Telephone
School/Unit
Position
For team applications only
Team Name
Please list names of other team members (to a maximum of three).
Note that teams may of any size, but no more than three members may be named.
Title / First name / Last name
Applicant Declaration
I/We (print name of applicant or team rep.) ………………..…………………………………………………apply for a Commendation for Excellence in Support of the Student Experience
Sign: / Date:

COMMENDATION FOR EXCELLENCE
IN SUPPORT OF THE STUDENT EXPERIENCE

APPLICANT PROFILE

Name
Current Position
Work History at UofA / (Briefly detail any positions you have held at the University of Adelaide prior to your current position)
Context of Contribution / (Describe the particular contribution that you have made to the activity, service or program described in the application, and its context within your current role).
Name
Current Position
Work History at UofA / (Briefly detail any positions you have held at the University of Adelaide prior to your current position)
Context of Contribution / (Describe the particular contribution that you have made to the activity, service or program described in the application, and its context within your current role).
Name
Current Position
Work History at UofA / (Briefly detail any positions you have held at the University of Adelaide prior to your current position)
Context of Contribution / (Describe the particular contribution that you have made to the activity, service or program described in the application, and its context within your current role).
Name
Current Position
Work History at UofA / (Briefly detail any positions you have held at the University of Adelaide prior to your current position)
Context of Contribution / (Describe the particular contribution that you have made to the activity, service or program described in the application, and its context within your current role).

COMMENDATION FOR EXCELLENCE
IN SUPPORT OF THE STUDENT EXPERIENCE

WRITTEN STATEMENT

  1. Overview

(Approx. half a page)

2.Description

(Description of activity, service or program. Approx. half a page)

3.Impact

(An account of the ways in which the activity, service or program has had a significant and sustained impact in support of the student experience. This account should incorporate appropriate evidence in support of the claims made. Evidence may include, but is not limited to: SELTs or other formal surveys; endorsements from students, staff and industry partners; peer review; participation, retention, and assessment data; and other awards or formal recognition. Approx. two pages.)

COMMENDATION FOR EXCELLENCE
IN SUPPORT OF THE STUDENT EXPERIENCE

REFERENCE LETTER

(The reference letter should be from the head of the applicant’s faculty, department, school or administrative unit. In the case of team applications, the reference should be from the head of the primary team representative’s faculty, department, school or administrative unit, but should apply to the team as a whole. The letter should describe the strategic impact of the activity, service or program described in the application and its value to the school/faculty/unit/division, and the University of Adelaide.)