| LAND FORCES 2021 Young Innovator Award |
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| ENTRY FORM |
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| 1. Name, Address and Date of Birth of Nominee: |
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| 2. Name and address of Nominee's Employer: |
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| 3. Declaration of Australian Citizenship: |
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4. Name, Job Title and Employer of Nominator:
(include phone number, email and postal address) |
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5. Brief Description of Project on which Nominee worked:
Innovation can be described simply as something that is either new to the adopter or that changes the adopter’s circumstances and/or behaviour – and it may be a combination of all three. Please frame your description using this framework as guidance. (Attach additional pages if necessary - marked as Annexe A) |
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6. Description of Nominee’s Contribution to the Project:
(Attach additional pages if necessary - marked as Annexe B) |
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7. Description of Nominee’s Originality and Innovativeness in meeting the challenges of the project concerned:
(Attach additional pages if necessary - marked as Annexe C) |
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| 8. If successful, how will the Nominee use the Scholarship to advance his/her career? |
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(NB – the Nominee has the right, when approached, to decline the nomination for any reason he or she may choose. Deliberately falsifying data on the entry form will result in immediate disqualification) |
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| 9. Name and Approval of Authorised Nominee: |
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