Leadership in Advocacy Awards Nomination Form

Leadership in Advocacy Awards Nomination Form

Research Canada’s Leadership in Advocacy Awards were established by Research Canada’s Board of Directors to honor outstanding advocates for medical, health and scientific research. The Emerging Leader in Advocacy Award is presented to an individual who has completed their education within the last five (5) years and who demonstrates outstanding leadership in advocating for medical, health, and scientific research in Canada. The Leadership in Advocacy Award is presented to an individual and/or organization who/which has made outstanding efforts in advocating for Canadian health research at the local, provincial and/or national level.

Nominees may be an individual or organization/company/institution who or which represents or is drawn from a stakeholder group across the health innovation continuum: government, academe, industry, non-governmental (not for profit sector), patients, health consumers. All nominees must be Canadian.

Nominations are accepted from Research Canada’s Members, Supporters and Partners. A secondary nominator is required for the nomination to be considered and cannot originate from a current member of Research Canada’s Award Selection Committee. Any nomination submitted may be considered for up to two award cycles.

    I am submitting a nomination for (required):

    Nominee

    Nominee Name (required)

    Nominee Title (required)

    Nominee Address (required)

    Nominee Phone (required)

    Nominee Email (required)

    Primary Nominator

    Nominator 1 Name (required)

    Nominator 1 Title (required)

    Nominator 1 Address (required)

    Nominator 1 Phone (required)

    Nominator 1 Email (required)

    Secondary Nominator

    Nominator 2 Name (required)

    Nominator 2 Title (required)

    Nominator 2 Email (required)

    Date:

    Reason for the Nomination:
    Please describe the nominee’s significant accomplishments and relevant contributions to the Canadian health research advocacy effort. (Please describe why they deserve this award in 250 words or less):

    For Emerging Leader in Advocacy Award Nominations (optional)
    Please provide any details regarding future advocacy plans and/or the anticipated impact of the nominee on health research advocacy. (250 words or less):

    Please attach the following documentation below:

    A letter of recommendation from each nominator
    Curriculum Vitae of the nominee or if an organization/company/institution, a description of mission, mandate, activities, size, successes and other relevant information, and any other material that supports the nomination.

    Letter of recommendation from Nominator 1 (doc or pdf only)

    Letter of recommendation from Nominator 2 (doc or pdf only)

    Curriculum Vitae of the nominee or if an organization/company/institution, a description of mission, mandate, activities, size, successes and other relevant information.

    Any other material that supports the nomination (You may attach ZIP or RAR file)

    If you’re having problems attaching files, please email them directly to award@rc-rc.ca.

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