Make a nomination for the Byron Kakulas Medal

Key dates

  • Opening date:  15 June 2022
  • Closing date: 08 August 2022 (midnight)

Who can make a nomination?

  • Australian nationals or permanent residents

Who can be nominated?

  • Individuals based in Western Australia, or
  • Small teams (up to 5 members)
  • If a team is nominated, some members may be located outside of Western Australia, providing the  team is primarily based in WA

There is no restriction on the type of individual or team who can be nominated. They might be a researcher, clinician, policymaker, health administrator, leader of a health NGO, leader of a community organisation, philanthropist, business leader, media figure or indeed anyone who has had a transformational impact on medical research, health policy, clinical practice, clinical service and/or community outreach.

Who is not eligible for nomination?

  • Organisations and businesses
  • Individuals or teams based outside of Western Australia

Byron Kakulas Medal Nomination Form

Byron Kakulas Medal Nomination Form

Nominations for the Byron Kakulas Medal will only be accepted by completion of this online form. The deadline for nominations is 08 August 2022. Please contact Professor Norman Palmer at kakulasmedal@perron.uwa.edu.au should you have any queries.

Who is making the nomination?

Who are you nominating?

Please indicate if you are nominating an individual or a team?
Ideally consent would be given but is not obligatory. Please check the box to confirm that the individual nominee or the team is aware of the nomination or gives full consent to being nominated

Individual nomination

Team nomination - with up to 5 members

Nomination

Complete using 1000 words or less.
Complete using 500 words or less.
Complete using 200 words or less.

Referees

Provide details of three individuals, who can be approached for independent advice on the nominee's achievements or contribution.

Attachments

File Upload. .doc, .docx or.pdf file formats only. 3MB per file. Maximum of 10 supporting documents including a 2 page bio-sketch or CV for the individual or each team member being nominated. Attachments may include reviews or commentary found in the media, medical literature or by made by medical experts, community organisations or others commenting on the nature and scale of the impact achieved by the individual or team.
Maximum upload size: 3MB

Enquiries

Please email all queries regarding the nomination process and criteria to Professor Norman Palmer