CSPC 2022 Trailblazer Award Nomination Form

Nominator’s Information

First Name *

Last Name *

Email *

Phone *

Address

City

Province/State

Country

Organization/Educational Institution*

How did you learn about the nomination process?
—Please choose an option—FacebookTwitterCSPC websiteOther

Nominee's Information

First Name *

Last Name *

Email *

Organization/Educational Institution*

Trailblazer Award Category*
(Select which category applies to the nominee. Please ensure the selection of the appropriate category, as if a wrong category is selected for a qualified candidate, it will not be considered) For distinction of the two categories please carefully read each award description.
Science PolicyInnovation Policy

Nominee’s Biography*
(No more than 400 words)

#1 Impact Statement

Please describe how the nominee has impacted Science Policy (for Science Policy Award) OR Innovation Policy (for Innovation Policy Award) in Canada through one (or more) of the selected criteria.* (700 words)

#2 Selection Criteria

Please select any that may apply and provide a justification for each selected criteria* (400 words maximum per criteria)
Select your criteria:

Policy making

Advancing research

Mobilizing knowledge

Community-building

Championing/advocating

Capacity-building

Enhancing productivity/development

Enhancing social innovation

#3 Demonstration of leadership and dedication

Describe how the Nominee has shown leadership and sustained commitment in blazing the trail.* (500 words)

The information in the application is considered as confidential (marked above with an *asterisk) and the CSPC judges will not release any of them.

Nominee’s CV*
Please upload the nominee’s CV (maximum 5 pages) to this nomination.

Files must be less than 8 MB.
Allowed file types: gif|jpg|jpeg|png|pdf|doc|docx|ppt|pptx.

Additional Sources