Forbes Norris Award Nomination

Your Name:*

(No self-nominations, please)
Your Position:*
Your Email:*
Name of Nominee:*

(Who would you like to nominate?)
Position(s) of Nominee:*
Nominee's Email:*
Please submit a written nomination of 800 words that addresses the following: What activities of the nominee have enhanced the quality of life of people living with ALS/MND? How has this individual contributed as a thought-leader in the advancement of ALS/MND clinical or care management? This can be in the area of Literature, Advocacy and/or Education. How has the nominee adopted a global approach to their endeavours to fight ALS/MND? What makes this individual exceptional in the global ALS MND Community?*
In what way is the nominee participating in the delivery of outstanding ALS/MND patient compassionate care?*
Please identify a short, selective list of research activities led currently and over the last 10 years by the nominee. These activities must have made a significant contribution to the medical literature. in the search for the cause, treatment and/OR cure of ALS/MND.*
You may record any other comments that will assist the judges here. (200 words max)
Please include an appropriate citation to be included in the Certificate recognizing this award in the event that your nominee is successful. (200 words max)*
CV or Resume for Nominee*
Accepted file types: doc, docx, pdf, Max. file size: 128 MB.
Please use .doc, .docx, or .pdf
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