2025 AAG Fellow nomination form

Endorsement

The application will need to be endorsed by a Chair of the applicant's State/Territory Division Committee or AAG Board Member. Please state full name and and position of the person who has endorsed this application. Applicant must also ensure that the person endorsing your application sends an email to enquiries@aag.asn.au confirming this before the application deadline closes.

Endorsee - Chair of applicant's State/Territory Division Committee or AAG Board Member. *

Applicant name*

Division where applicant resides.*

Applicant has been an AAG member since. (One can check this in via AAG online account https://aag.asn.au/Web/Sign-in.aspx)*

The Fellow of AAG established in 1999 is intended to recognise the high professional standing of members in any field of gerontology. Applicants must have been a member for five years and meet four of the following criteria (including item 3 or 4). Please select as appropriate.*

1. Service on an AAG State or Territory Division Commitees or the AAG Board2. Higher qualifications in a relevant field3. Presentation at AAG National Conference4. Scholarship evidenced by publication5. Current membership of other relevant professional associations6. Service in the field of gerontology

Criteria 1: Service on an AAG State Division Committee or Board of Directors (please detail)

Criteria 2: Higher qualification in a relevant field. Please detail qualification obtained, field, institution and year and attach evidence. Please attach evidence of qualification obtained*

Criteria 3: Presentation at AAG National Conference. Please detail title of presentation(s), year(s) and location(s) of Conference and attach published/presented abstract.*

Criteria 4: Scholarship evidenced by publication. Please give citation details for one refereed publication in gerontology, in the Australasian Journal on Ageing or other refereed journal and attach a copy of title page.*

Criteria 5: Current membership of other relevant professional associations.

Criteria 6: Service to the field of gerontology. Please detail service beyond direct employment, for example, membership of a government working party or reference group, or membership of a committee of management of an aged care service, and provide the name and position of a referee who can vouch for this service.

If you need more space, upload a separate document clearly indicating what criterion or criteria.

On occasion, we have had applications submitted on the person's behalf without their knowledge. This is to ascertain who is submitting this application.*

I am submitting myselfI am submitting on behalf of someone elseI am submitting on behalf of someone else, and without their knowledge

Submitter's name

Submitter's email*

example@example.com

AAG Fellow nomination 2025

Endorsement

About the applicant