NOMINATION FORM
Please use this form for all nominations to ensure full and systematic consideration can be given to all nominations. Please use a separate form for each nomination and attach additional information as required.
NOMINEE DETAILS
Nominee’s name:
Corp. No:
Job title:
Section:
Primary Department:
BASIS FOR NOMINATION
1. Researchers nominated for this award are required to provide a one-page summary of research achievements with the following information:
· List three of the most significant research activities and explain why they are significant
· Comment on the nominee’s achievements and accomplishments in the past two years (2014, 2015) (e.g. describe how the nominee has made a significant impact to his/her research field and brought recognition to HMC)
· Recommendation by the departmental chairs/heads of department
2. Research Performance Indicators
Supplementary to the description given above, the following will be considered but not as a replacement:
2.1 Publication record: Total number of publications in the last two years. Please attach a copy of the list of publications along with the Journal Impact factor. Articles published in peer reviewed Journal with Journal Impact Factor 0.5 and above only will be considered. Case Reports, Letters to the Editor and review articles will not be considered.
2.2 Grants and awards/prizes:
· Total research grants won, including information on funding source
· International or national research prizes, awards and accolades
2.3 Official positions held, services and invitations: Membership in editorial boards and conference committees. Service as a reviewer and Invited presentations at scholarly meetings/workshops.
3. Other supporting information, if any
1. One-Page Summary of Research Achievements: (Note: Only research carried out while under the employment of HMC and approved by the Medical Research Center will be considered.)
2. Research Performance Indicators
2.1 Publication track record: Total numbers of Publications (Please attach a copy of the nominee’s publication list and highlight papers with highest citation counts and the journals with the highest impact factor.
(Note: Info provided here should be consistent with those in the benchmarking summary table)
2.2 Grants and Awards/Prizes: Total research grants won, including information on funding source; International or national research prizes, awards and accolades
2.3 Official positions held, services and invitations: Membership on institutional, national or international scientific advisory boards (briefly describe the role or objectives of each); Membership in editorial boards and conference committees (categorized under National / Regional / International);
Service as a reviewer (categorized under National / Regional / International journals, conferences or grant agencies); Appointment as external assessor; membership on visiting committees; Invited presentations at scholarly meetings/workshops (categorized under National/Regional/International - to provide a list of major lectures/seminars, including dates)
3. Other supporting information (Maximum 200 words) Please state dates and provide a brief description of achievements / contributions outside the traditional area of research which made an impact on his profession / area of expertise.
I confirm that the nominated individual demonstrates relevant key attributes and is suitable for recommendation for the award.
Name of the department
Chair/Executive Director:
Signature: / Date:
Please note that this nomination must be supported and signed by the relevant signatory from the Department. The evidence provided in support of this nomination will be used to select the Best Researcher Award recipient.
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