Please submit a nomination for one of the following Alumni Awards: 

1.  Lester Breslow Lifetime Achievement Award
This award is given annually to one or more living UCLA Fielding School of Public Health alumni who have demonstrated significant contributions and achievements to the public health profession.

2.  Recent Alumna/us Achievement Award
This award is given annually to one recent alumna/us (who graduated within the past 7 years (class of 2013 or later) who has demonstrated significant contributions and achievements to the public health profession thus far and exemplified excellence and dedication to their work.

Nominees will be ranked on career accomplishments, innovations in and contributions to the field of public health, research and publications, distinguished service, and volunteer efforts.

Please submit one online form per nomination. You may submit more than one nomination. 

Nominations due Tuesday, February 12, 2019

These awards will be announced at the Annual Ruth Roemer Lecture on April 24, 2019.


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* 1. Award Nomination

Nominator's Information

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* 2. Your First Name

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* 3. Your Last Name  (include maiden and married names if applicable)

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* 4. Your Email

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* 5. Your Phone

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* 6. Your Business/Company

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* 7. Your Business Title

Nominee's Information

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* 11. First Name

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* 12. Last Name (include maiden and married names if applicable)

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* 13. Email

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* 14. Phone

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* 15. Business/Company

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* 16. Business Title

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* 20. Upload nominee's curriculum vitae, including bibliography of significant publications (if applicable).

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 21. Upload a statement or letter describing nominee's qualification for this award.

You may wish to address the depth and breadth of the nominee's career accomplishments, contributions to the field of public health, research and publications, and/or distinguished service and volunteer efforts. The letter or statement should be no more than two pages.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 22. If you have any additional information, please share it here. 

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