2020 Laurels Nomination Form

INSTRUCTIONS FOR SUBMITTING YOUR NOMINATION:

1. Provide your name and contact information.

2. Select a category (National Leadership, Dedication to Community Service, or Increasing Health Equity through Innovation).

3. Upload a letter for each nomination describing why the nominee should be recognized with a particular award.

4. Enter a short biographical sketch for your nominee (no CVs, please).

Click here for more information about the Laurels Awards and a list of previous recipients.

Nominations must be received by 5:00pm EST on Wednesday, February 19, 2020. The awards ceremony will be held on April 16, 2020 at the Hilton Crystal City at Washington Reagan National Airport, just minutes away from Washington, DC.

*In addition to recognition at the Laurels Awards Ceremony and Luncheon, recipients receive complimentary attendance (including travel) to the 2020 Prevent Cancer Dialogue conference and the opportunity to network with leaders in the field.

Email any questions to Adrienne Harkness at adrienne.harkness@preventcancer.org.

Name *

First Name Last Name

Email Address *

Phone Number *

Area Code Phone Number

How did you hear about the Laurels Awards?

Which category are you nominating for (choose only one)? *

Cancer Prevention Laurel for National Leadership: Awarded to an individual who has shown exemplary leadership in cancer prevention or early detection at the national level in the U.S. An awardee will be an outstanding individual whose leadership and vision have inspired others to join him or her in working toward a shared goal which has made a difference in cancer screening or prevention. Cancer Prevention Laurel for Dedication to Community Service: Awarded to an individual who has demonstrated unwavering commitment to enhancing cancer prevention or early detection on the community level in the U.S. An awardee will be a remarkable individual who has identified and addressed gaps in meeting community needs in cancer prevention and screening. This commitment can be demonstrated through development and implementation of educational, clinical or research programs. Cancer Prevention Laurel for Increasing Health Equity through Innovation: Awarded to an individual or organization for innovative methods to increase health equity in cancer prevention and screening in communities across the U.S. An awardee will be an individual or organization that has identified and implemented innovations which increase health equity by improving or expanding services at the community level.

Please provide the name and contact information of your nominee:

Name *

First Name Last Name Suffix

E-mail *

Phone Number

Area Code Phone Number

Provide a letter for each nomination describing why the nominee should be recognized with a particular award. Upload your nomination letter here. *

Submit a brief biographical sketch of your nominee. (No CVs, please.) *

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2020 Cancer Prevention Laurels Award Nomination