Outbreak Hero Award, ASLM2018

ASLM2018 Outbreak Hero Award

The deadline for accepting nominations is Friday, 30 November 2018.

The ASLM2018 Outbreak Hero Award seeks to recognise an exceptional individual whose outstanding contributions and leadership have contributed to prevent and control an infectious outbreak.

These contributions may be a new innovation, new knowledge, or ways to improve professional practice. Importantly, the contributions should be above and beyond the call of duty and have had a long lasting impact in the public health sector.

For more information, please visit the ASLM2018 Awards webpage.

ASLM will recognise an exceptional individual who meets the following criteria:

The nominee’s must have contributed significantly to control an infectious outbreak at local and national level, through community work, health care, research or the coordination of interventions.
The nominee has made a lasting contribution to the standard of care, knowledge, regulation or practice in relation to outbreak response and prevention
The nominee has exhibited leadership and provided inspiration to others in the sector, as well as positively influenced public health, on a national and international level.

Nomination instructions:

To ensure that your nomination form is reviewed in a timely manner, it is critical to submit your completed nomination form (along with required and optional attachments) before Friday, 30 November 2018.
Email nominations are not accepted, only nominations submitted via this online submission form will be considered.
Posthumous nominees will not be accepted.
For inquiries, contact the ASLM2018 awards organising committee via awards@aslm2018.org.

“Outbreak Hero Award Award” nomination form:

Complete the nomination form below and select “Submit” to finalise your nomination. All fields are required unless otherwise noted.

Section 1: Contact Information of the Nominator

Salutation*

First Name(s) of Nominator*

Surname of Nominator*

Affiliation of Nominator*

Phone Number of Nominator*

Email Address of Nominator*

Section 2: Details of Nominee

Salutation*

Nominee First Name(s)*

Nominee Surname*

Nominee Home Country*

Nominee Phone*

Nominee Email Address*

Level of Education*

Section 3: Narrative to Describe Nominee’s Achievements:

Please describe the circumstances in which the nominees has contributed to the response or prevention to infectious outbreaks.*

Please describe the impact of the nominee’s to the standard of care, knowledge, regulation or practice in relation to outbreak response and prevention.*

Please describe what makes this nominee’s leadership unique.*

Please attach the CV of the outbreak hero nominee. (Attachment in PDF, WORD or JPEG format)*

Please upload letter of reference #1. (Attachment in PDF, WORD or JPEG format)*

Please upload letter of reference #2. (Attachment in PDF,WORD or JPEG format)*

Please upload letter of reference #3. (Attachment in PDF, WORD or JPEG format)*

Please attach any other supporting documentation you would like to provide. (Attachment in PDF, WORD or JPEG format)

Drop files here or

Section 4: Declaration of Intent

Confirmation*

I hereby confirm that the information provided in the nomination form above is accurate to the best of my knowledge.