ATTACHMENT A

2015

Research Evaluation Committee Nomination (Please refer to the information pack before completing this form)

Institutions are to electronically return a signed copy of this form for each nominee and a spreadsheet with the nomination details for all nominees.

Name of nominating institution:

The University of Newcastle

Name of nominee:

Title: e.g.: Mr/Mrs/Dr/Associate Professor/Professor

First name:

Family name:

....................................................................... ......../............/ 2014Signature of nominee Date

..........................................................................Position

As the nominee, your signature is to indicate that you have been consulted by the nominating institution, that you agree to take part in the Research Evaluation Committee for ERA 2015 nomination process and that you understand the time commitments involved for those nominees who may have been chosen for Research Evaluation Committees for ERA 2015.

Signature of nominating institution DVCR or equivalent:

.......................................................................... ......../............/ 2014Signature Date

...........................................................................Please print full name and occupation or profession of institution signatory.

As the signatory for the Institution, you are in agreement that you understand the time commitments involved for those nominees who may be chosen for Research Evaluation Committees for ERA 2015.

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