Love your WOW factor. Nomination form

Love your WOW factor. Nomination form

Nominations must be received no later than the close of business on Wednesday 10th January 2018 Completed nomination forms can be left at any Westpac branch. Or send to: Manager Communications and Marketing Westpac Bank-PNG-Ltd P.O. Box 706 Port Moresby, N.C.D Please ensure that you do not include original documents with your nomination as they cannot be returned. For more information about the Westpac Outstanding Women Awards, please call the Westpac PNG Marketing team on (675) 322 0810 or email marketingpng@westpac.com.au Choose one Award category that you wish the nominee to be considered for, noting the selection criteria on page 7. PricewaterhouseCoopers Private Sector Award Steamships Not for Profit Award SP Brewery Entrepreneur Award Trukai Community Award IBBM Young Achiever s Award Moore Printing Sports Award Precinct Public Sector Award supported by the Papua New Guinea Australia Partnership Nominee name: Date of birth /Age: Organisation name: Industry: Position/title: Company address: Residential address: Business phone: Mobile: Email: Describe the nominee s current role and responsibilities: Why are you nominating this person/yourself? Nomination form page 2

Nomination form List the names and contact details for at least two (2) business referees. These business referees may be contacted to verify information supplied in this nomination form. Referee 1 Name: Position: Company: Email: Mobile: Referee 2 Name: Position: Company: Email: Mobile: Eduction history Name(s) of school/college/university No. of years attended Qualification achieved Employment history Name(s) of school/college/university No. of years attended Qualification achieved Leadership Please provide at least two (2) examples that demonstrates outstanding achievement in your ability to lead others to achieve challenging objectives, to influence others and to set aspirational standards for other women. Mention what was achieved as a result of your leadership and if other people were involved (max 400 words). Nomination form page 3

Nomination form Good governance Please provide at least two (2) examples that demonstrate your track record of managing responsibility and upholding the highest levels of integrity and good governance. This could include good decision-making skills and maintaining integrity and honesty. Mention what was achieved as a result of your good governance knowledge and skills and if other people were involved (max 400 words). Success Please provide examples that demonstrate your outstanding achievement in academic, sporting, professional and/or business activities. Mention if other people were involved (max 300 words) Values Please provide examples that demonstrate how your personal and business principles have led the way in community and corporate life. Mention what was achieved as a result (max 300 words). Nomination form page 4

Nomination form Community Please provide at least two (2) examples that demonstrate how you have helped others and led the way for women to overcome challenges in the community. Mention what was achieved as a result of your community leadership and if other people were involved (max 300 words). Please attach any relevant information that may support these activities and achievements such as newspaper articles, references or certificates. Please do not include originals as they cannot be returned. What are your long-term business and personal aspirations? What do you wish to achieve? Nominator details (if different to the nominee): Name: Organisation name: Industry: Position/title: Company address: Residential address: Business phone: Mobile: Fax number: Email: Nomination form page 5

Terms and Conditions 1. Each finalist residing outside of Port Moresby will receive economy class return airfares, single room accommodation at Gateway Hotel including breakfast. A daily stipend/per diem of K50 for lunch and dinner will be provided for each finalist. The exact arrival and departure details will be arranged individually with each finalist according to their personal circumstances. 2. If the winners of the PricewaterhouseCoopers Private Sector, Steamships Not for Profit, SP Brewery Entrepreneur or DFAT Precinct Public Sector Award supported by the Papua New Guinea Australia Partnership reside outside of the city that the forum is to be held, they will receive economy class return airfares, single room accommodation at a 3-4 star hotel, three meals or an equal amount in allowances and registration fees to attend the 2018 Australia PNG Business Forum. The exact arrival and departure details will be arranged individually with each finalist according to their personal circumstances. 3. The winner may claim incurred educational expenses up to K5,000 over a three-year period as part of the Education Grant prize. Receipts must be supplied for education-related expense reimbursements or official invoices for payment by Westpac. The prize cannot be taken as cash and residual monies at the end of the given period remains the property of Westpac. Any dispute over what constitutes education-related expenses or invoices will be referred to the Managing Director of Westpac Bank-PNG-Ltd and payment made at his/her discretion. 4. The donation will be made at the discretion of Trukai management based on the audited information and credentials of the chosen charity. 5. If the winner of the IBBM Young Achiever s Award resides outside of Port Moresby, accommodation and three meals per day will be provided at The ToRobert Business Training Centre. This prize is valued up to K26,000. This prize does not include transportation whilst residing in Port Moresby. 6. The Westpac Outstanding Woman of the Year Winner will receive economy return airfares, 3-4 star single accommodation and three meals (or daily stipend) and return transfers to attend one of The Australian Executive Women s Leadership Symposiums in Australia during 2018. Other networking opportunities may be offered. The exact date and location will be mutually agreed between Westpac and the award recipient. The Terms and Conditions apply for a term of 12 months from the announcement as a finalist and by submitting a nomination form you accept these Terms and Conditions. All information submitted on the nomination form must be true and correct at the time of nominating. As nominee, I give permission to Westpac Bank PNG Ltd and affiliated sponsors to use my details to promote their products and services. The nominee will attend all presentations and activities they have qualified for as a finalist and be available to assist with promoting the events associated with the Westpac Outstanding Women Awards if asked. If the nominee is an Award winner, she agrees to make time available for promotional appearances during the term of the Awards, abiding by the terms set out below: If requested, the nominee will endorse Westpac Bank PNG Ltd, the Awards or associated award sponsors. Westpac Bank PNG Ltd or the sponsor requesting the award winner s services must give the winner at least 7 days notice of the time, date and location of the promotion. The sponsor must make sure the promotion does not interfere with business commitments of the winner. For each requested appearance, the requesting sponsor will meet the travel and accommodation expenses of the winner. During the term of the Awards, the nominee will not participate in any activities that may harm the reputation of Westpac Bank PNG Ltd or the Awards or sponsors. Westpac Bank PNG Ltd may use the nominees images and identity to promote the Awards. By entering the Awards, nominees and winners agree that the event organisers can use their images for promotional and marketing purposes across all media in PNG and abroad. The judges decision is final and no discussion or correspondence will be entered into. Westpac Bank PNG Ltd will not be held liable for any loss, injury or damage, which results directly or indirectly from the nominees participation in the Westpac Outstanding Women Awards. Do not submit original documents to the Westpac Outstanding Women Awards as they cannot be returned. The Awards are open only to women who are citizens or permanent residents of PNG and who are 18 years or older. Employees of Westpac Bank-PNG-Ltd and previous Award winners are not eligible to enter. Winners must use the full title of their Award in any publication or promotion they undertake. If at any time during the judging phase a finalist or their business goes into bankruptcy, voluntary administration, receivership or liquidation the finalist is required to advise the event organisers and accepts that they may no longer be a finalist. In this eventuality the event organisers will put forward the next finalist receiving the highest number of votes in the respective category as the replacement finalist. Westpac reserves the right to withdraw any title and prizes from an Award winner should they participate in any activities that may harm the reputation of Westpac Bank PNG Ltd or the Awards or sponsors. The judges may request further information from the nominees at their discretion at any time. Ownership and title to these awards shall be the exclusive property of Westpac Bank-PNG-Ltd. I have read and agree to the Terms and Conditions of the Westpac Outstanding Women Awards. Nominee name: Signature: Date: Nomination form page 6