Organisation:

Project Title:

Project team member names:

Key Contact;

Name:

E-mail:

Contact number:

Nominated by (if different from above);

Name:

E-mail:
.
Organisation:

Contact number:

Award Category

—Please choose an option—Outstanding individual contributionOutstanding team effortOutstanding co-designEmerging Star Award for early career professional/researcher (less than 5 years experience in the field)Research impact awardOutstanding partnership and collaboration

Project Background: 300 words (max):

Project Goals/Objectives: 300 words (max):

Project Impact:

Partnerships:

Supporting Materials

Supporting material to support the submission

Upload supporting documentation such as publications, articles, promotional material etc. If you would like to submit multiple documents, please email them to enquiries@equallywell.org.au and reference the project title.

Δ