Nomination Form

Nominator Information

Nominator 1

Name*

Institutional Email*

Affiliation*

Country/Territory*

Nominator 2

Name*

Institutional Email*

Affiliation*

Country/Territory*

Nominee Information

Name*

Title*

Affiliation*

Institutional Email*

Country/Territory*

Personal Website*

ORCID

Please note that all materials must be submitted in English.

Nominee Biography*0 / 2500

^†No more than 2500 characters including spaces in total.

Please describe the nominee's major scientific contributions, their significance to the field, their impact on human health or the progress of medicine, and their measurable achievements at the time of nomination.*0 / 7500

^†No more than 7500 characters including spaces in total.

5–10 of the nominee's most representative academic publications.

DOI*Note (summarize the main contributions, if not covered above)

Nominee's major honors, awards, and funded research projects*0 / 1000

^†No more than 1000 characters including spaces in total.

Nomination Letter (PDF/ZIP)*

^† A letter signed by the two nominators, outlining the reasons
for nominating the candidate. Max size 10MB.

Supporting Documents (Word, PDF or ZIP)

Maximum file size: 10MB.

Data Protection Notice

The personal data provided in this form will be used solely for the purpose of administering the award process, including nomination review, evaluation, and selection.The submitted materials may be accessed by authorized committee members and staff involved in the evaluation process.Personal data will be processed in accordance with applicable data protection laws, including the General Data Protection Regulation (GDPR).