Stage 2 Nominee Statement

{"elements":[{"isDiscrete":false,"hidden":false,"name":"Nominee First Name","readOnly":false,"id":563555276,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Nominee Surname","readOnly":false,"id":563555277,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Email","readOnly":false,"id":563555278,"type":"emailElement"},{"isDiscrete":false,"hidden":false,"name":"Department","readOnly":false,"id":563555279,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"HOD","readOnly":false,"id":563555280,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"HOD email","readOnly":false,"id":563555281,"type":"textFieldElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"Team Award","value":"0-teamaward"},{"text":"Individual Staff Award","value":"1-individualstaffaward"},{"text":"UG Award","value":"2-ugaward"},{"text":"PG Award","value":"3-pgaward"}],"name":"Award","readOnly":false,"id":563555282,"type":"radioElement"},{"isDiscrete":false,"hidden":false,"name":"Co-nominee(s) ","readOnly":false,"id":563555283,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Co-Nominee(s) Email","readOnly":false,"id":563555284,"type":"emailElement"},{"isDiscrete":false,"hidden":false,"name":"Supporting Statement","readOnly":false,"id":563555285,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"1662473478632_0.6650388679473709_0.35895428753520475","readOnly":false,"id":563555286,"type":"commentElement"},{"isDiscrete":false,"hidden":false,"name":"Criteria 1","readOnly":false,"id":563555287,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"Criterion 2","readOnly":false,"id":563555288,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"Criterion 3","readOnly":false,"id":563555289,"type":"textBoxElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"true","value":"0-true"},{"text":"false","value":"1-false"},{"text":"","value":"2-"},{"text":"true","value":"3-true"},{"text":"false","value":"4-false"}],"name":"Bibliography of Evidence","readOnly":false,"id":563555290,"type":"attachment"}]}

Nominee First Name

Nominee Surname

Department

Who is your Head of Department?

HOD Email Address

Team Award

Individual Staff Award

UG Award

PG Award

If you have co-nominees, please enter their name(s) below:

Co-Nominee(s) Email(s)

Supporting statement from Applicants HoD/ Line Manager/ Personal Tutor (if student)

Please use the boxes below to tell us how you meet the criteria outlined in this document.

WAPCE Criteria

Evidence can be cited within the application directly (as quote/ statistic) or referred to in brief with the full evidence source cited in an "Evidence Bibliography", which can be attached to your application and will not count towards your word count for the three criteria. The evidence itself can be links to webpages, photos, videos, reports or other documentation that shows the relevant activity you have undertaken. This does not have to be submitted with the application, but should be available if the Selection panel requests to see it/ elements of it.

Tell us how you meet criterion 1

How do you feel you meet criterion 2

Tell us how you meet criterion 3

You may use this field to submit any supporting evidence you wish to provide with your application.

Attach file

No files are currently attached.

Privacy notice

The data provided in this form will be used to process your application to take part in WAPCE. Your application will be recorded and associated with your details. The data is for the use of the University and will not be disclosed to external organisations, other than those acting as agents for the University. We will share this information with the review panel and the WIE Team. Your data is also subject to the Alumni, Donor and Stakeholders Privacy Notice and the central University Data Protection Policy.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

Spam prevention

Warwick Institute of Engagement

Stage 2 Nominee Statement

Failure to load reCAPTCHA