Nomination Form - The Ohio State University Wexner Medical Center

The Schottenstein Prize
2015 Nomination Form
Eligibility
This prestigious prize provides national and international recognition to a physician or biomedical scientist who has made
extraordinary and sustained leadership contributions to improving healthcare; or who has successfully pursued innovative
biomedical research with demonstrated translational benefits to patient care. Those honored will be practitioners and/or
scientists whose accomplishments and contributions have taken place over a career of dedicated and focused scientific
discovery. The prize is awarded biennially. All nominations must be received by January 31, 2015 at 11:59 p.m. Eastern Time.
Nomination Process
The nomination process is a two-step process. No nomination will be considered unless both steps have been completed.
Deadline for all entries is January 31, 2015 at 11:59 p.m. Eastern Time.
Complete the required fields on the following page regarding the nominee and the nominator.
Send all required documentation via email to [email protected]. In the subject line enter the name of the nominee
along with Schottenstein Prize Nomination Information. For example:
Subject: John Smith – Schottenstein Prize Nomination Information
These items must be sent for the nominee to be considered:
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A letter from the nominator describing the primary reasons by which the nominee merits consideration for the prize.
Relevant criteria might include scientific innovation, creativity, leadership, education, dedication and importance of the
nominee’s work to the field of cardiovascular research. Consideration will also be given to the nominee’s role as mento
of young researchers and/or clinicians.
Nominee’s curriculum vitae
A brief, one-page biography including other awards received by nominee
A list of 6-8 peer-reviewed journal references that support the nomination. Do not send reprints.
Two letters of reference from individuals outside of the nominating institution
Supporting letters from up to three additional colleagues familiar with the nominee’s work.
Hard copies may be mailed instead of emailing. However, items must be postmarked by January 31, 2015 to be considered.
Late entries will not be accepted. Please mail any hard copy entries to the following:
Dr. Thomas Ryan, Director of the HVCc/o Tracy McHugh
ATTN: Schottenstein Prize Nomination Committee
Ohio State’s Heart and Vascular Center
452 W 10th Ave
Columbus OH 43210
Please complete the form on the next page
The Schottenstein Prize
2015 Nomination Form
Nominee Information
First Name: *
Last Name: *
Title: *
Organization: *
Address: *
Zip: *
State: *
City: *
Phone: *
Fax: *
Email: *
Nominator Information
First Name: *
Last Name: *
Title: *
Organization: *
Address: *
Zip: *
State: *
City: *
Phone: *
Fax: *
Email: *
Send all required documentation via email to [email protected].
Hard copies may be mailed instead of emailing. However, items must be postmarked by January 31, 2015 to be considered.
Late entries will not be accepted. Please mail any hard copy entries to the following:
Dr. Thomas Ryan, Director of the HVCc/o Tracy McHugh
ATTN: Schottenstein Prize Nomination Committee
Ohio State’s Heart and Vascular Center
452 W 10th Ave
Columbus OH 43210

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