Nomination Form for the Nanyang Award 2014 – MERITORIOUS ACHIEVEMENT (for former employees) Section 1 - Particulars of Nominee

Nominee Name* School/Dept/Office/Centre** 1 ______1 ______2 ______2 ______3 ______3 ______4 ______4 ______

* use one nomination form per nominee per Award. ** please indicate the nominee’s last School/Dept/Office/Centre before leaving NTU’s employ

Section 2 - Particulars of Nominator

Name: ______(If student, please also provide Matric No. or Registration Card No. ______)

School/Dept/Office/Centre ______(If student, please also provide year and course of study: ______)

Signature of Nominator: ______Contact Number: ______Date: ______

Instructions for submitting nominations: All sections and sub-sections of the nomination form must be completed. Submission with incomplete nomination form will be at a disadvantage as the Selection Panel may not be able to fully appreciate the value of the contributions made by the nominee.

Send the original signed nomination form and documentary evidence (if any) to support the nomination, directly to: Nanyang Award c/o Office of Human Resources. Your submission should also be emailed to [email protected]

All submissions must be received by 28 November 2014.

Section 3 - The Nomination

The evaluation of the nomination will be based on the following key criteria:  Impact – for contributions or accomplishments which created significant positive impact to the image, competitive edge, growth of the University or achieved excellence beyond the immediate organizational level.  Influence – for contributions or accomplishments which have created a positive influence to the University’s community and beyond, inspiring fellow colleagues, students as well as the community at large.

Section 3.1 Provide a description of the exemplary achievements, service and accomplishments over and above usual job responsibilities, and why they are significant.

Last Updated by OHR on 25 Sep 2014 - MA Section 3.2 Describe how the nominee has made an impact on the University’s vision and mission, and how the reputation/international standing of NTU is enhanced

Section 3.3 Describe how the actions, achievements and contributions of the nominee have inspired others.

Section 3.4 List any national, regional and/or international accolade and recognition received by the nominee.

Section 3.5 Provide any other information and attach documentary evidence (if any) to support the nomination.

Last Updated by OHR on 25 Sep 2014 - MA Page 2