2026 AdPha KC Leong Memorial Registrar of the Year Award – Nomination Form

This is the nomination form for the 2026 KC Leong Memorial Registrar of the Year Award.

For more information, including key dates, eligibility and nomination requirements, please refer to: AdPha Training Program Awards

Details of person being nominated

Please enter below the details of the person being nominated for the award.

First name:(Required)

Last name:(Required)

Email address:(Required)

State / Territory:(Required)

Program site:(Required)

Is this a self-nomination or are you nominating a peer for this award?(Required)

Self-nomination

Peer-nomination

Are you an AdPha member:(Required)

Yes

No

Member number:

You must be an AdPha member to be eligible for this award.

Your details

First name:(Required)

Last name:(Required)

Email address:(Required)

Workplace:(Required)

Next steps

This entry comprises Part 1 of the Nomination Process. After this form is submitted, the nominee will then be contacted directly to proceed with Stage 2 of the Nomination Process (submission of supporting documentation). Please refer to the Training Program Awards page on the AdPha website for more information.

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