Nomination Form
The Cancer Research UK Future Leaders in Cancer Research Prize
Deadline: 31st March 2017
The Future Leaders in Cancer Research Prize recognises an individual who has completed their PhD within the last ten years and has demonstrated the potential to achieve world-leading status by producing international quality research.
The successful recipient of this prize will have produced international quality research, and demonstrated ambition and aspirations consistent with the potential exhibited by current world leaders at that stage of their career. Up to three awards will be made per year.
The recipient will receive an honorarium of £10,000, a commemorative trophy, and free attendance at the NCRI Conference (held on 5th-8th November 2017) where the presentation ceremony will take place. The successful recipient of this award will be notified in July 2017.
Terms and Conditions of the Cancer Research UK Prizes are available at http://www.cancerresearchuk.org/funding-for-researchers/how-we-deliver-research/our-research-prizes

Eligibility

·  On the 31st May of the year of the award candidates must be within 10 years of having been awarded their PhD.
·  Candidates must have produced international quality research outputs, and be committed to building their research career within the UK.
·  Candidates cannot nominate themselves.
·  Candidates need not be in receipt of funding from Cancer Research UK, or have been supported, either directly or indirectly, by Cancer Research UK.
·  There are no restrictions with regard to the race, age, gender, nationality, or religious or political views of a candidate.
·  The Prize will be presented to an individual investigator.

How to Nominate

The deadline for receipt of nominations for the 2017 Prize is 31st March 2017.
There is no restriction on how many candidates can be nominated by an individual scientist, nor on the number of individuals wishing to support one nomination.
Whilst nominators are expected to discuss the prize nomination with the nominee, the broader confidentiality of the prizes scheme should be maintained.
The following materials must be submitted in a nomination:
1.  Details of the nominator, candidate and the supporter for the nomination.
2.  A completed nomination form that includes a summary statement of no more than 2000 words, describing the research accomplishment(s) of the candidate and the significance and impact of his/her research. Publications supporting these contributions may be directly referenced within the text; with full citations given at the end of the statement (references are not included in the word limit).
3.  One letter of support from an expert in the field, who must come from outside the nominee's institution. This can be included with the nomination form or sent directly to Cancer Research UK at the email address below. The name of the supporter should be included in the nomination form. In their letter, the supporter should state their relationship to the nominee.
4.  The candidate's CV, including a list of their most relevant publications (up to a maximum of ten publications).
Nominations must be submitted electronically to .
Paper nominations will not be accepted. A nomination should not be considered submitted until Cancer Research UK has issued an email confirming this. Confirmations will be sent within five working days of the submission deadline.
Checklist:
Completed nomination form including a description of the candidate’s accomplishments
Letter of support
Candidate’s CV

PART 1

Details of Nominator

Please give your contact details and position.

Title / Initials
First Name
Last Name
Department
Faculty / School
Host Institution
Address line 4
Address line 5
City/Town
Postcode / Country
Email
Telephone
Relationship to candidate (no more than 100 words)


PART 2

Details of Candidate

Please give contact details for the nominated candidate and details of their current position.

Title / Initials
First Name
Last Name
Department
Faculty / School
Host Institution
Address line 4
Address line 5
City/Town
Postcode / Country
Email
Telephone
Fax (if available)


PART 3

Details of Supporter

Please give contact details for the referee who has agreed to provide a letter of support for the candidate. The letter may be included with this nomination or submitted directly to Cancer Research UK () prior to the closing date. If submitted separately, the letters should clearly indicate the candidate’s name and the award for which he/she is being nominated.

Full name and title
Full postal address
Email
Telephone / Fax
PART 4
Nomination Statement
Please give a brief statement of no more than 2,000 words: the Prize for which the candidate is nominated for; the research accomplishment(s) of the candidate; the significance and impact of his/her research. Any supporting publications cited in the text should be fully referenced (up to maximum of 10 authors).

Please email the completed form to

Cancer Research UK Future Leaders in Cancer Research Prize 2016 IN CONFIDENCE

Page 1 of 6