Nominations must now be received by Friday, December 16, 2022

Please refer to the Terrance Keenan Award Brochure when completing your application. Using this form, nominators should submit:
  • Contact information for the nominee, the nominator, and two individuals from an entity other than the nominee’s foundation, who support the nomination and are willing to be contacted by the selection committee. Separate letters of endorsement are not required.
  • Answers to the nomination questions, which provide background information on the nominee and speak to the nominee’s achievements, leadership qualities, and principal contributions to the field of health philanthropy.
  • No more than three attachments that illustrate the nominee’s achievements, which may include articles authored by the nominee, publications produced under the nominee’s leadership, and media articles. Attachments may include hyperlinks.
Nominations must be received by Friday, December 16. Questions should be sent to GIH Program Director Ann McMillan at amcmillan@gih.org. For more information, visit https://www.gih.org/tools-resources/awards/.

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* 1. Nominee Information

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* 2. Nominator Information

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* 3. Reference #1

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* 4. Reference #2

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* 5. Describe the nominee’s professional journey and achievements. What makes this individual an outstanding health funder? How has this individual shown leadership and strategic vision? What have their most significant contributions to the field been thus far?
500 Word Limit

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* 6. Describe how this individual has taken risks, shown innovation, and exhibited the flexibility and creativity needed to address the nation’s most pressing health problems.
500 Word Limit

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* 7. Describe how this individual has fostered, mentored, or inspired those working in the field.
500 Word Limit

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* 8. Accompanying Attachment 1

PDF, PNG, JPG, JPEG, GIF file types only.
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* 9. Accompanying Attachment 2

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 10. Accompanying Attachment 3

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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