GEAHM Award Nomination Form

Nominate someone for an award or submit your nominee packet to accept a nomination.

The Gender Equity in Academic Health and Medicine Committee seeks to recognize individuals who support the success of women and gender diverse individuals in academic health and medicine. We also work to create culture change in the area of recognition of the important roles of cisgender/transgender women and gender diverse individuals at OHSU. To recognize such individuals, the committee has created a total of five awards.

Eligibility:

The awards are open to all OHSU schools, colleges, and the affiliated units.
The Mentoring, Discovery, Clinical Excellence, and Emerging Leader awards are open to faculty.
The Professional In-Training award is open to OHSU students, postdocs, residents and fellows.

For more information about the requirements of each award, visit https://www.ohsu.edu/gender-equity-in-academic-health-and-medicine/geahm-leadership-conference-and-awards#section-74336

APPLICATION PROCEDURE

Nominator: submit the letter of nomination to the GEAHM Award committee by Dec. 9th using this form.
The nominee will be notified about their nomination by the GEAHM Award committee and asked to submit their letter(s) of support, CV, brief statement and other documents.

Please indicate if you are nominating someone else or submitting your packet to accept a nomination*

Select

Enter your OHSU.edu email address*

Enter your first and last name*

Nominee Information

Award Category*

Select

Nomination Letter*

A letter of nomination (1-page, less than 400 words). The nomination letter should specifically address how the individual’s accomplishments relate to the purpose of the award.

Nominee Email*

Enter an OHSU.edu email address

Nominee First and Last Name*

Nominee Credentials*

MD, PhD, PharmD, MPH, DDS, etc.

Nominee School and Department*

Where is your primary appointment?

Nominee Statement of Accomplishments*

Your Brief Personal Statement (200 words or less, text only) summarizing your accomplishments and why you are a strong candidate for the award.

If your statement includes graphs, tables, etc., please attach a Word or PDF document containing your statement with graphics in the document upload field below.

Upload your CV and documents*

At least one additional letter of support from colleagues.
Curriculum vitae (highlighted with accomplishments relevant to the award).
Any other requested documentation specific to the award.

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