Nomination Form
1. I wish to nominate
Title
Please specify
Mrs
Miss
Ms
Mr
Dr
Other
First Name
Family Name
Date of Birth
Position
Company Name
Company Address
Suburb/Town
State
Postcode
Industry Type
Email Address
Business Phone
Facsimile
Private Number
Mobile Number
2. My contact details
Title
Please specify
Mrs
Miss
Ms
Mr
Dr
Other
First Name
Family Name
Date of Birth
Position
Company Name
Company Address
Suburb/Town
State
Postcode
Industry Type
Email Address
Business Phone
Facsimile
Private Number
Mobile Number
Your relationship to the nominee (eg. Colleague)
Please tick if you wish to remain anonymous
3. Please indicate the Awards Category for which you have made a nomination
Award Category
Chief Information Officer
Human Resources Director
Sales & Marketing Director
Innovator
Chief Financial Officer
Entrepreneur
Director
Chief Executive Officer
Professional Services Leader
Young Leader
Leader of the Year
4. In the space below, summarise why you feel the nominee deserves an award.
What has the nominee achieved in terms of demonstrable bottom line business results?
What has the nominee achieved in terms of building organisational capability?
What has the nominee achieved in terms of customer satisfaction and focus?
What has the nominee achieved in terms of building human capital?
What additional information would you like to share regarding the merit of the nominee for a JML Human Capital Leadership Award?
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