2020 Distinguished Faculty Awards Nomination Form

Distinguished Faculty Award 2020 Nomination Form

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Nominee Name

Nominee E-mail Address

Nominee Department

Number of Years Nominee Has Been at WUSM

Award Selection

Distinguished Clinician

Distinguished Community Service

Distinguished Investigator (Jr. Faculty)

Distinguished Investigator (Sr. Faculty)

Distinguished Educator/Mentor (Mentoring of Faculty)

Distinguished Educator/Mentor (Graduate Student Teaching or Mentoring)

Distinguished Educator/Mentor (Graduate Medical Education/Residents or Clinical Fellows)

Distinguished Educator/Mentor (Postdoctoral Research Mentoring - PhD, OT, PT, MD and MD/PhD)

Letters of SupportSupport Letters: Three letters are required. Please list below 3 individuals who will provide letters of support for your nominee. It is the responsibility of the nominator to request support letters. Letters of support must be received by October 23, 2019. Letters should be sent to Kim Vaninger at vaningerk@wustl.edu. NOTE: For Educator/Mentor Awards that pertain to students or trainees, one letter must be from a student or trainee in the nominee's pertinent educational/training program. For Community Service Awards, one letter must be from a member of the community outlining the nominee's contributions and impact on the community detailing the nature, extent, duration and impact of the community service. For Investigator Awards, letters should focus on nominee's scientific contributions/excellence and the impact of their work.

Nomination Statement: (please review the eligibility and nomination criteria). Please write a brief statement (100 words or less) describing the rationale for the nomination. Please briefly highlight her/his qualifications and contributions. The Office of Faculty Affairs will request the nominee's CV

Nominator Name

Nominator Department

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