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Panpa Bulletin : June 2006
ENTRY FORM 2006 Candidate information (confdential for judges only) 2006 Hegarty Prize To be received at PANPA by Friday, July 14, 2006 NOMINEE’S NAME NEWSPAPER CURRENT POSITION HOW MANY YEARS PREVIOUS POSITION HELD HOW MANY YEARS PREVIOUS POSITION HELD HOW MANY YEARS EDUCATION/DEVELOPMENT ACTIVITIES (please attach separate pages if required) OUTSTANDING ACHIEVEMENTS/PERFORMANCE (please attach separate pages if required) MANAGEMENT POTENTIAL OTHER COMMENTS NOMINATOR’S NAME NOMINATOR’S POSITION NOMINATOR’S PHONE NOMINATOR’S E-MAIL We agree to abide by the judges' decision and understand that no correspondence will be entered into. We also understand entry material cannot be returned and entry material submitted may be used by PANPA for promotional purposes. PLEASE COMPLETE THE FORM, ATTACH ANY SEPARATE PAGES AND SEND TO: PANPA 2006 Hegarty Prize PO Box 6425, South Sydney Business Hub Alexandria, NSW 2015 Australia NAME: DATE: ENDORSEMENT FROM GM/MD/CEO SIGNATURE: