CSPC 2026 Science Policy Trailblazer Award Nomination Form

Nominator’s Information

First Name *

Last Name *

E-mail *

Phone *

Address

City *

Province/State *

Country *

Institution/organization/government/municipality *

Nominee's Information

First Name *

Last Name *

E-mail *

Institution/organization/government/municipality *

Trailblazer Award Category *
Select the category that best applies to the Nominee. Please ensure you select the appropriate category; if the incorrect category is selected for a qualified candidate, the nomination will not be considered). To understand the difference between the four categories, please read the Criteria Description page.

Science for PolicyPolicy for ScienceInnovation PolicyScience & Society

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

Area(s) of Impact:

The Nominee must have catalyzed change that has had a positive and significant impact on Canadian Science, Technology, Innovation and Society through one, (or up to three), of the following:*

Policy makingAdvancing researchMobilizing knowledgeCommunity-buildingChampioning/advocatingCapacity-buildingEnhancing productivity/economic developmentEnhancing social innovationPublic engagement/education

Selection Criteria:

1. Impact Statement: Describe how the Nominee’s work has (1) catalyzed change and (2) impacted Canadian Science, Technology, Innovation and Society. Please use quantitative and/or qualitative data to demonstrate the significance and transformative impact of the Nominee’s contributions (no more than 800 words).*

Specifically describe:

• The depth and breadth of the impact.

• The novelty and creativity of the work.

2. Relevance to Area(s) of Impact: Describe how the work and the impact of the Nominees’s contribution are relevant to each selected Area of Impact (see above) (no more than 300 words for each Area of Impact). *

3. Role of Nominee in Impact: Elaborate on the contribution the Nominee played in driving the impact and achieving the results (no more than 300 words per criterion). *

4. Leadership and Dedication: Describe how the Nominee has demonstrated leadership, dedication, and sustained commitment to the advancement of science, innovation and society (no more than 400 words). *

How did you learn of the nomination process?
—Please choose an option—FacebookTwitterLinkedInCSPC websiteOther

Please specify if Other

Describe how the Nominee has demonstrated leadership, dedication and sustained commitment to the advancement of science, innovation and society. * (Maximum 400 words)

Required Document:

Nominee’s CV *
Please upload the Nominee’s CV (maximum 5 pages).

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

Additional Sources of Information
(Please list specific sources that the judges can consult for more information about the Nominee, e.g., websites, books, articles, reports, films, etc.)