Trailblazer Award Nomination Form CSPC 2024

Nominator’s Information

First Name *

Last Name *

Email *

Phone *

Address

City

Province/State

Country

Institution/organization/government/municipality*

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

Nominee's Information

First Name *

Last Name *

Email *

Institution/organization/government/municipality*

Trailblazer Award Category*
Select which category applies to the Nominee. Please ensure the selection of the appropriate category, if the wrong category is selected for a qualified candidate, it will not be considered). For distinction of the four categories, please carefully read each award description in the Trailblazer Criteria page.

Science for PolicyPolicy for ScienceInnovation PolicyScience & Society

Nominee’s Biography*
(Maximum 400 words)

Selection Criteria:

Impact Statement: Describe how the Nominee’s work has (1) catalyzed change and (2) impacted the Canadian Science, Technology, Innovation and Society. Please use quantitative and/or qualitative data to demonstrate the significance and transformation of the Nominee’s impact* (Maximum 800 words)

Specifically describe:

• The depth and breadth of the impact.
• The novelty and creativity of the work.

Area(s) of Impact:

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

Specifically describe:

• 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

• Role of Nominee in Impact: Elaborate on the role that the Nominee played in contributing to the impact and results achieved

Policy making

Advancing research

Mobilizing knowledge

Community-building

Championing/advocating

Capacity-building

Enhancing productivity/development

Enhancing social innovation

Public Engagement/Education

Leadership and Dedication:

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

Required Document:

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