2024 BSD Distinguished Faculty Award Nomination Form

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Complete the following fields to submit a faculty nomination for the 2024 Award cycle.

All required materials due upon submission, no later than Tuesday, May 7, 2024 for full consideration by the Faculty Advisory Committee.

Upload Nomination Materials here

Email *

Nominator Information

All current BSD faculty (except current Faculty Advisory Committee members) are eligible to nominate and to be nominated for each of these awards

Nominator First & Last Name *

Nominator's Title *

Rank, leadership role

Nominator's Department *

Nominator Email *

Nominee Information

Current elected members of the Faculty Advisory Committee are ineligible for nomination; see list of members on the FAC website.

Nominee First Name *

Nominee Last Name *

Nominee Rank *

Assistant Professor

Associate Professor

Professor

Other:

Nominee Track *

SOM

BSD

Other:

Nominee's Department *

Award *

Please select the Award category, for full details on the award description, eligibility, materials required see the OFA website.

Distinguished Clinician

Distinguished Investigator

Distinguished Educator & Leader

Distinguished Community Service and Advocacy

Distinguished Leader in Diversity and Inclusion

Distinguished Leader in Program Innovation

Francis H. Straus Mentorship

Michael Reese Lectureship

Awardee Category *

Junior Faculty Award: Instructors, Assistant Professors, early Associate Professors (4 yrs or less)

Senior Faculty Award: Late Associate (more than 4 years) or Full Professors

Clinical Faculty Member (Straus)

Non-Clinical Faculty Member (Straus)

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