National Space Grant Distinguished Service Award Nomination Form

National Space Grant Distinguished
Service Award Nomination Form

The NSGC Distinguished Service Award was established to recognize individuals whose life and career have had an enduring impact in a science, engineering, or education field that is related to Space Grant and/or NASA endeavors. When submitting a nomination please consider the following:

The candidate’s connection to the Space Grant mission. Although other submissions will be considered, candidates who are involved in science, engineering, or education fields in the U.S. and whose work was directly tied to NASA endeavors will be given preference.
The candidate’s contribution to this mission. Did the candidate go above and beyond their nominal career responsibilities. Was their contribution outside the normal scope of their responsibilities.
The impact of the candidate’s contributions, i.e., an estimate of the number of students, faculty and/or the public impacted by these contributions and the extent of that impact, e.g., statewide, regional or across the entire U.S.
Mention any known endeavors the candidate has made to be inclusive of all students, faculty and the public, particularly under-represented and under-served groups.

"*" indicates required fields

Information on Nominator

Name*

First Last

Email*

Space Grant Affiliation*

State*

Information on Nominee

Name*

First Last

Basis for Nomination*

Please provide a detailed statement setting forth the basis for this nomination. This statement should be in paragraph form and not be a list of links to websites. Please limit your statement to 4000 characters or less.

It is the intention of this award that the recipient be able to accept this award in person at the award banquet. Are you aware of any reason why this nominee would be unable to attend the award ceremony?*

Yes

If you are aware of such information, please explain.

Please describe the nominees link to the Space Grant program? Please note that a direct relationship with Space Grant is not required for the nomination.*

Please select the option that best describes the nominee's connection to the Space Grant mission.*

Name

This field is for validation purposes and should be left unchanged.

If this nominee is selected for the award you will be asked for the following information:

First draft of a citation for use on the Foundation website and in the award ceremony handout materials.
Recommendation on the method of contacting the awardee

National Space Grant Distinguished Service Award Nomination Form