Nomination for Distinguished Service Award Form

The Distinguished Service Award of Indiana Academy of Science is bestowed upon individuals who have been recognized as having supported the Academy through service exceeding any normal expectation. Award recipients have been recognized by the Council, and acknowledged through awards made at the annual Academy meeting.

Nominations for the Distinguished Service Award will be reviewed by the Awards Committee and recommendations will be made to the Council. Individuals receiving the Distinguished Service Award will be recognized at the annual meeting of the Academy where their service will be acknowledged by the membership of the Academy and the Award recipient will be given a plaque to bear witness to the Academy’s recognition of this service.

Nominees must be current members of the Indiana Academy of Science. Nominations must be received by October 15 of each year. Please submit all information as pdf files. Please send questions or comments to: awards@indianaacademyofscience.org

Nominations must include the following:

This Nomination Form
A narrative documenting the qualifications of the nominee
A CV highlighting the extent and nature of scholarship

The undersigned Members of the Indiana Academy of Science have the honor to recommend the following Academy member for the Distinguished Service Award:

Your Name *

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Last

Your Position *

Your Email *

Your Address *

Address Line 1

Address Line 2

City

State

Zip Code

Name of Nominee *

First

Last

Nominee Position *

Nominee Email *

Nominee Address *

Address Line 1

Address Line 2

City

State

Zip Code

Names of at least 5 Academy members supporting this nomination: *

Upload all supporting files and artifacts here: *

Click or drag files to this area to upload. You can upload up to 5 files.