Event Registration:

AUSTRALIA AWARD NOMINATION 2025

Attendee Information

Complete Registration
NOMINATE A CANDIDATE

PLEASE NOTE: Nominee must reside in the AUSTRALIA Region.

All fields are mandatory, unless otherwise indicated.

About You (Nominator)

Please enter a first name
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Please enter a last name
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Please enter a valid phone number including country code
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Please enter a organization
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Please enter a title/position
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About Your Nominee

Please enter a nominee first name
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Please enter a nominee last name
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Please enter a nominee organization
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Please enter a nominee job title
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Please enter a nominee email address
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Please enter a valid url
e.g. https://womeninpayments.glueup.com
If you input more than 0 characters your LinkedIn Profile may not display properly

Please enter a nominee phone number
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Please enter a nominee address 1
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If you input more than 0 characters your Nominee Address 2 may not display properly

Please enter a nominee city
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Please enter a nominee country
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Please enter a nominee postal/zip code
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Award details:

Please select an option

Please enter between 500 and 1,000 characters
If you input more than 0 characters your Please describe how the nominee meets the criteria for this award (min 500 โ€“ 1000 max characters). may not display properly

Please enter between 500 and 1,000 characters
If you input more than 0 characters your Briefly outline the nomineeโ€™s experience and most significant achievement(s) in her organization or within the payments industry in the area of leadership, mentorship, integrity, and diversity. (500 - 1000 max character) may not display properly

Please enter a list any recognition or awards received by the nominee, the organization that awarded them and date awarded.
If you input more than 0 characters your List any recognition or awards received by the nominee, the organization that awarded them and date awarded. may not display properly

Please enter between 500 and 1,000 characters
If you input more than 0 characters your Biography (min 500 โ€“ 1000 max characters) may not display properly
Click here to upload a file
Please upload a valid upload a profile picture of the nominee (max 1000 x max 1000 pixels, 2mb)
Select one or more options

References

Please enter a reference 1 first name
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Please enter a reference 1 last name
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Please enter a reference 1 organization
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Please enter a reference 1 job title
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Please enter a reference 1 email address
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Please enter a reference 1 phone number
If you input more than 0 characters your Reference 1 Phone Number may not display properly

Please enter between 100 and 300 characters
If you input more than 0 characters your Reference 1 : What is the capacity in which they know the nominee? (min 100 โ€“ 300 max characters) may not display properly

Please enter between 100 and 300 characters
If you input more than 0 characters your Reference 1: What are the reasons that this reference supports this nominee? (min 100 โ€“ 300 max characters) may not display properly

If you input more than 0 characters your Reference 2 First Name may not display properly

If you input more than 0 characters your Reference 2 Last Name may not display properly

If you input more than 0 characters your Reference 2 Organization may not display properly

If you input more than 0 characters your Reference 2 Job Title may not display properly

If you input more than 0 characters your Reference 2 Email Address may not display properly

If you input more than 0 characters your Reference 2 Phone Number may not display properly

If you input more than 0 characters your Reference 2 : What is the capacity in which they know the nominee? may not display properly

If you input more than 0 characters your Reference 2: What are the reasons that this reference supports this nominee? may not display properly

If you input more than 0 characters your Reference 3 First Name may not display properly

If you input more than 0 characters your Reference 3 Last Name may not display properly

If you input more than 0 characters your Reference 3 Organization may not display properly

If you input more than 0 characters your Reference 3 Job Title may not display properly

If you input more than 0 characters your Reference 3 Email Address may not display properly

If you input more than 0 characters your Reference 3 Phone Number may not display properly

If you input more than 0 characters your Reference 3 : What is the capacity in which they know the nominee? may not display properly

If you input more than 0 characters your Reference 3: What are the reasons that this reference supports this nominee? may not display properly

Contact Person

Please enter a valid phone number including country code
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Please enter a first name
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Please enter a last name
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Find Company

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Consent

This checkbox is mandatory