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Discovery Awards Nomination Form

We’re accepting nominations for the 2019 Discovery Awards, if you would like to recognize the efforts of someone in the science, technology and innovation areas, please take a moment to fill out our nomination form.

Nomination Categories:

Professional of Distinction – An individual who is a leading innovator, a role model for people who choose science as a career
Science Champion – An individual who promotes science and technology to the public in above and beyond the normal avenues of communication
Innovation – A company that has produced a commercially viable product or service and is ready or has already launched it into the market
Emerging Professional – An individual age 35 and under who demonstrates intellectual achievements, excellence and potential for ongoing growth and development

**Recommendations for Science Hall of Fame can be emailed to **

Please note: Nominee must be informed about this nomination and understand that further information is required should they be a finalist. Also, please specify the name of one individual for Emerging Professional, Science Champion, and Professional of Distinction categories; the Innovation category may specify an Organization/Company/Laboratory/Team name. The Discovery Awards take place in late November.

Discovery Awards Nomination Form

Nominee Information

Work Address:
City
State/Province
Zip/Postal
Country
Home Address:
City
State/Province
Zip/Postal
Country
(Only Emerging Professional Award)

Nominator Information

Please provide us with your information so that if we have any additional questions, we may contact you. Thank you.
Your Address:
City
State/Province
Zip/Postal
Country

Question 1:

(200 word limit)

Question 2:

(200 word limit)

Question 3:

(200 word limit)

Question 4:

(200 word limit)

Question 5:

(200 word limit)

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