The Henry G. Friesen International Prize
in Health Research
Nomination Form
The Prize:
The Henry G. Friesen International Prize was established to honour the leadership, vision and innovative contributions of Dr. Henry G. Friesen in Medical Research and Health Research Policy.
Nominees shall be individuals whose work in health-related fields has gained international recognition and are able to articulate to peers and the public the significance, challenges and opportunities in health research.
The Prize is a joint project of Friends of Canadian Institutes of Health Research with the Canadian Academy of Health Sciences and is financed through a fund established by Friends of CIHR. A detailed description and terms of reference of The Prize are available at www.fcihr.ca.
Nominee: _____________________________________________________________
Address: ________________________________________________________________________
Phone: ( )____________________ E-Mail: __________________________________________
Basis of the Nomination:
Please provide key information regarding the nominee's career and stature, major contributions to health research and health, and distinguishing accomplishments.
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Primary Nominator: Secondary Nominator:
Name: _________________________________________ ______________________________________
Signature: ______________________________________ ______________________________________
Date: __________________________________________ ______________________________________
Phone: _________________________________________ ______________________________________
E-Mail: ________________________________________ ______________________________________
The following additional information is required to accompany this form:
- Curriculum Vitae of the nominee
- Letters of endorsement from both nominators
- Any other printed or electronic material that directly speaks to the nomination
Send the completed Nomination Package marked Confidential to the attention of:
The Henry G. Friesen International Prize in Health Research
Advisory Committee