The Strathcona Medal – Nomination Form 2018

thestrathconamedal

nomination form: 2018


The Strathcona Medal, awarded annually at Presentation Night,stands alone as Strathcona’s method of recognising someone from within our School community of past students who has demonstrated excellence in her chosen field and exceptional contribution to the wider community in the spirit of the School motto ‘Bravely, Faithfully, Happily.’ The Medal shall be accompanied by a citation explaining the justification for the Award.

The service need not necessarily be high profile. For example, a major and exceptional scientific breakthrough would be high profile, whereas 50 years of voluntary service to a charity or community project would qualify equally.

Please also note that, in any given year, an Award need not be made if, in the opinion of the Committee, a suitable nominee has not been found. Conversely, in any one year multiple Awards could be made to equally high nominees.

Thank you for taking the time to nominate someone for this Award.

Guidelines:

  1. The recipient shall be a past student of Strathcona.
  2. The recipient may be living or deceased.
  3. Nominations may be re-submitted although continuous nomination of thesame person is to be discouraged.
  4. The expiration of a number of years may enhance a person’s nominationowing to greater length of service.
  5. Nominations are to be made on an official form, giving the details of theperson nominated and the justification for the nomination. This form is valid only when signed and dated by both the nominator and the seconder.
  6. Nominations should be kept confidential at all times prior to the announcement of the Award.
  7. It shall be the responsibility of the Committee to check the details of the nomination before determining the Award.

The Nominee:

Name: ………………………………………………………………………………..

Address: ……………………………………………………………………………......

……………………………………………………………………………………………….. Home Phone: …………………………….. Mobile Phone:………………………………..

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

Year the nominee left Strathcona as a student ……………………………………….

Reason for nomination:

On the following pages please provide information on the nominee’s qualifications for this Award.

Please feel free to attach any further documentation to this form.

Corroborator details:

Please list here names, addresses (including email) and phone details of other people who know your nominee well and can add to the details provided by you. Good examples might be family, neighbours, work colleagues, fellow committee members, etc.

The Nominator:

Name: ……………………….……………………….……………………….………………...

Address: ………………………….………………….……………………….………….……...

Home phone: ……………………….……………………….……………………….…………

Mobile phone: ……………………….……………………….……………………….………..

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

The Seconder:

Name: ………………………….……………………….……………………….……………..

Address: ………………………….……………………….……………………….……………

Home phone: ………………………….……………………….……………………….………

Mobile phone: ………………………….……………………….……………………….……

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

I hereby declare that the enclosed information is true to the best of my knowledge and I hereby propose the above nominee for consideration for The Strathcona Medal.

Nominator’s signature: ………………………………………………….. Date …../…../…..

Seconder’s signature: ……………………...…………………………….. Date …../…../…..

Please return, marked CONFIDENTIAL, using one of the following methods:

Scanned, by email:

MrsJo Wilson

Director of School & Community Relations

By post:

The Chair – Strathcona Medal Committee

C/- Reception

Strathcona BGGS

34 Scott Street

Canterbury, Victoria, 3126

In person:

Leave personally at the School Reception.

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