Enter last name (surname or family name). Please use Title Case, eg Smith, NOT UPPERCASE or all lowercase.
Select a title from the list.
Enter your first name. Please use proper case, eg Frederick, NOT UPPERCASE or all lowercase.
Enter the formal title of the position held in the employing organisation.
Please enter the full name of your Department within the organisation.
Select the employing organisation from the drop-down list. If it is not included in the list, please enter its full name in the 'If other' box.
Enter a simple street address (32 Smith Avenue) into the Postal Address 1 box.
If your address comprises additional street information, (eg Unit 4), enter this information in the Postal Address 1 box and enter the standard street information (32 Smith Avenue) in the Postal Address 2 box.
Landline or mobile phone number, including country/area code, if required.
Enter a valid and full email address (formatted as name@xyz.com). Only one e-mail address can be entered.
Describe the areas for which you are prepared to provide a reference.
Select the year or years that you are available to act as referee. To select more than one year, after clicking in one year, hold down the [Ctrl] key and click the other years. Note that while still holding down the [Ctrl] key, a selected year can be unselected by clicking it again.
Select the number of applications you are prepared to referee in any one year from the drop-down list.
The Channel 7 Children's Research Foundation would like to acknowledge your valuable contribution to the Foundation. Select 'Yes' if we can identify your contribution in a list of independent referees in our next annual report (not attributable to the application/s you have assessed).
Type the selected password twice. Ensure that this password is not provided to any unauthorised person. Do not use it in email correspondence.