NOMINATION FORM MH QAZI ALUMNI STAR PERFORMER AWARD

Eligibility Criteria for Nominations

The eligibility criteria for nominations is as follows:
The nominee must be an alumni of University of Lahore (MME Program)
1. Personal Information

Title (Prof./ Dr.):
Name:
Designation:
Organisation:
PMDC Registration. No:

Address:

City:

Country:

Tel/ Mobile No:

Fax No:

Email:

Website (if any):

2. Academic Qualification

Degree:

Title/ Nomenclature:

Awarding Institution

Passing Year:

Remarks/ Distinction (If any):

Professional Memberships/ Affiliations (Attach membership evidence)

Institution/ Body

Position/ Role/ Membership

National/International

From – To (Year)

Professional/ Job Experience with notable area of expertise (Attach CV focusing on position held at organizations with brief job history)

Organization

Position Held

Duration (Year)

Nature of Job/ Area of Expertise

Publications (papers, articles, reports, books etc.) (List max 10 most outstanding publications related to the nominated/ claimed work)

Title of Publication(s)

Type (Book, Paper,Journal Article etc.)

National/ International

Impact Factor(as per HEC Indexing Criteria)

Distinctions/ Awards conferred (National/ International) (List only Professional Honors and Awards which are conferred)

Award/ Honor Title

Notable Area/ Achievement

National/International

Year Conferred

Significant work/ Innovative idea/ project/ research/ process/services/ contribution/ achievement(s) for which nomination is being made. (Provide supporting documents/ evidence)

Area of Contribution: (please tick as appropriate)
Academia & ResearchCurriculumAssessmentProgram EvaluationStudent EngagementTechnology and Process Development
Any other

Define Type:

Effort: (please tick as appropriate)
IndividualTeam effort (mention role such as Lead/ Member)

Tangible impact in Socio-economic terms:

Level:

Economic term:

Number of beneficiaries/ community:

Reason/ justification for selection of nominee for the award
In the space below please justify why the award should be granted to the nominee (300-500 words)

words. Please limit to 500 words or less.

Documents to be submitted
The following documents are to be submitted
1. Curriculum vitae of the nominee with recent photograph
2. Evidence of honors and awards (list only professional honors and awards that are conferred. Do not
list membership of professional society which is obtained by application)
3. List of publications with evidence
4. Supporting document provided in this nomination form for information
5. Undertaking by Nominee

I, the undersigned affirm that the above furnished information is correct to the best of my knowledge. I grant to University of Lahore (UoL), the right to copy, reprint, quote or publish any of the above information as part of its Award program or other public communication. Nomination material becomes the property of UoL and may not be returned. Moreover, I have never been barred from holding any public office or convicted by any Court of Law.
Nominee Full Name:

*Incomplete applications will not be entertained. Applications are evaluated by a blind, peer review process conducted by a panel of experts. The decision of the review panel is final. If in the opinion of the review panel there are no submissions considered suitable during a given year, no innovation Award will be awarded.

In the space below please attach supporting documents

NOMINATION FORM MH QAZI ALUMNI STAR PERFORMER AWARD

Eligibility Criteria for Nominations

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