New Prize Form (Externally Funded)[Insert prize name]

PRIZE DETAILSPrize components:

Cash, $

p.a.

$ by external contributor $ by UNSW (if partly internally funded)In-kind, please describe:

Number of prizes awarded annually: First award ceremony: (month & year), for student achievement in (academic year)SELECTION CRITERIA

Best performance in: Other conditions:

No award shall be made in any year in which there is not a candidate of sufficient merit.

PRIZE ARRANGEMENTSBeneficial fund – payment method and commitment term:

Annual payment for years (payment will be requested in August prior to award) Other:

Endowed fund – initial funding amount: $

EXTERNAL CONTRIBUTOR DETAILSContributor / organisation name:ABN (if applicable): Contact person (if applicable): Position title: Address: Email: Phone:

SOURCE OF CONTRIBUTION Gift (donation) – subject to UNSW Gift Provisions

(attached) Bequest Grant

Sponsorship – Sponsorship Agreement is required Event based fundraising

INTERNAL TRANSFER DETAILS (if partly internally funded)

School: Faculty / Division:

Project ID: Fund code:

Department ID:

Approval from UNSW Finance attached to transfer from OP001 to FC101? Yes NoSIGNATURE

Faculty / Division:School:

.............................................................................

..[Signature]: Dean, Faculty of....

.......................................................

...Name

......................................

..[Date]

.............................................................................

.[Signature]: Development Associate

.......................................................Name

.....................................[Date]

This form is to be completed by: Development Manager Office UsePlease return signed copy to: UNSW Foundation Development Associate, Cc: prizes@unsw.edu.au Prize

code:

Disbursement of money from the Prize must be authorised by UNSW Foundation