Honorary Fellowship form

* required field

First/Given Name: *

Surname/Family Name: *

Email: *

Name of nominee *

Email address

Telephone:

Address

Previous association/contribution to LJMU

Current association with LJMU

Links to Liverpool / Merseyside / North West

Reasons for timing of nomination / award

Reasons for nomination - overview and supporting statement

Relevant websites

Potential for involvement with LJMU

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