2024 LSQ QIMR BERGHOFER WOMAN OF INFLUENCE AWARD – Nomination Form

Nominations close at midnight on 30 June 2024.

NOMINEE INFORMATION

Personal Title (Professor/Dr/Ms/Mx etc)*

First Name*

Last Name*

Organisation*

Position*

Phone number*

Email*

LinkedIn profile

This will help us promote your achievements if you are shortlisted.

NOMINATOR INFORMATION
Leave blank if you are nominating yourself. Otherwise, please complete all fields.

Personal Title (Professor/Dr/Ms/Mr etc)

Nominator First Name

Nominator Last Name

Nominator Organisation

Nominator Position

Nominator Phone

Nominator Email

ELIGIBILITY CRITERIA

Award nominees must:

identify as a woman and be in the mid to late stages of their career
work for an LSQ member organisation in any area of the life sciences
not have won this award in the past five years
not have served on the LSQ Board of Directors for the past three years.

AWARD JUDGING CRITERIA

Judges are seeking a trailblazing woman whose career has significantly advanced the growth and success of the Queensland life sciences sector.

Your submission should provide evidence that you (or your nominee) has:

made contributions that enhance the Queensland life sciences industry beyond your current role
demonstrated leadership by inspiring and empowering others, breaking down barriers and leading initiatives that advance women in the life sciences
shaping the next generation of the life science sector through initiatives such as mentoring and university collaborations
implementing innovation and creativity in the life sciences industry
helped raise Queensland's life sciences profile and capabilities.

Please tell us why you (or your nominee) should receive the Woman of Influence Award*

Provide a maximum of 250 words, ensuring you address the Award Judging Criteria above.

Nominee Headshot*

Please provide a high-quality portrait as a jpg or png. Note this will be used in all award publicity and media communications.

CV*

Please provide a 2pp (max) CV to support your application.

Letter/s of Support as PDF (optional)

Applicants are encouraged to provide letters of support from external parties to strengthen their entry. Please attach these as PDFs.