ASCLS Awards Application/Nomination

Choose Award
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Please select the award for which you are applying or nominating.

Award Applicant/Nominee Information

Applicant/Nominee First Name
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Applicant/Nominee Last Name
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Street Address
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City
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State
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Zip Code
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Phone
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Email
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ASCLS Member Number
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ASCLS Join Year
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Year Started Working as a Professional
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Co-Applicant/Nominee First Name
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Co-Applicant/Nominee Last Name
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Nominator Information (if applicable)

Nominator Name
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Constituent Society or Regional Position
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Constituent Society or Region
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Nominator Street Address
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City
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State
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Zip Code
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Nominator Email
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Nominator Phone
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File Uploads (if applicable)

Upload Attachment 1
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4Mb maximum file size. PDF or Word Document only.

Upload Attachment 2
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4Mb maximum file size. PDF or Word Document only.

Upload Attachment 3
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4Mb maximum file size. PDF or Word Document only.

Upload Letter of Nomination
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4Mb maximum file size. PDF or Word Document only.

Websites and Publications

Website Address/URL
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Publication Name
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Publication Issue 1
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Volume and Number. PDF will be submitted below.

Upload PDF of Issue1
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4Mb maximum file size. PDF only.

Publication Issue 2
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Volume and Number. PDF will be submitted below.

Upload PDF of Issue 2
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4Mb maximum file size. PDF only.

Publication URL for Issue 1
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Publication URL for Issue 2
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Scientific Awards

Title of Project
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Project Entry Category
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Short Description of Project Subject Matter Presented
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Up to 500 characters.

Coauthors or Project Collaborators
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Please copy and past the names (as they should appear), ASCLS member numbers, and email addresses of any Coauthors or Project Collaborators.

Has the research project been done in the last two (2) years?
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Scientific Research Award File Upload
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Upload a document with an explanation, in fewer than 300 words, of the impact of this project on patient care and current laboratory science practice.

Upload copy of materials or example of materials
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