Nominations must be received by Friday, December 6, 2019.

In addition to completing this form, please submit: 
  • A background profile of the nominee, including a summary of the nominee’s principal contributions to the field of health philanthropy and how the individual meets the specific criteria for this award. This may take the form of a letter that addresses eight key criteria (described in the brochure) regarding the nominee’s achievements and leadership qualities. The letter should not exceed five single-spaced, typed pages. The extent to which the letter makes a succinct case for the candidate is more important than the letter’s length.
  • Two individuals must second the nomination. They do not have co-write separate letters of endorsement. One of these individuals must be from an entity other than the nominee’s foundation.
  • 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. Nomination letters may include hyperlinks in lieu of attachments.

Please email the nomination letter and any attachments to Natasha Khanna, Communications Director, at nkhanna@gih.org. For more information, visit our website.

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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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