IEEE Nuclear and Plasma Sciences Society
Nomination for the Medical Imaging Scientist Award

Deadline: Nominations must be received by July 19, 2002

Description:
This award is given to an individual in recognition of outstanding contributions to the field of medical imaging science. The prize, consisting of $2,000 and a plaque, is awarded in even-numbered years at the IEEE Medical Imaging Conference.

In selecting the recipient of this award, primary consideration will be given to nominees who have made significant innovations in the field of medical imaging science.  Other factors include a nominee’s overall research contribution and his/her influence on medical imaging science through education.  

There are no specific eligibility requirements for this award; however, where nominees have otherwise equal qualifications, preference will be given to the nominee who is a member of IEEE.
  
Instructions:
Nomination packets should be submitted to:

Margaret Daube-Witherspoon, Ph.D.
Chair, IEEE MIC Awards Committee
11316 Smoke Rise Court
Fairfax Station, VA 22039

Phone: (703) 250-5091
Fax: (703) 250-5092
e-mail: daubew@bellatlantic.net

The nominator should provide the information requested in the following nomination form.   Please do not submit materials beyond those requested.  

This form is available in both RTF (for use in Microsoft Word) and PDF formats.  If you are using Word, you can type the requested information directly into this document.  Otherwise, use additional sheets to answer parts 3-9.

IEEE Nuclear and Plasma Sciences Society
Nomination for the Medical Imaging Scientist Award

1. 	Candidate
Name (first, middle, last):	
Title: 	
Organization:	
Work address:	

Home address:	

Phone number(s):	
e-mail address:	
IEEE member?  Yes		No		If yes, Member no.

2. 	Nominator
Name (first, middle, last):	
Signature:		Date: 
Title: 	
Organization:	
Address:	

Phone number(s):	
e-mail address:	
IEEE Member number

3. 	Proposed citation (30 words or less; typically stated as “For contributions to…”)

4. 	Education
Educational Institution	Location	Degree	Year

5. 	Professional history
Time period	Organization	Position held and responsibilities

6. 	Description of candidate’s technical achievements and other contributions to the field of medical imaging science (not to exceed 2 pages)
7. 	List of candidate’s ten most significant publications and patents  
8. 	Submit copies of three representative publications
9. 	Submit two additional letters in support of the candidate (not to exceed 2 pages each)