Nomination Form (submit online):
- Nominee’s contact information
- Citation in 200 words or less listing contributions, honors and awards
(Full Name), (Suffix) is (enter current position title) at (enter institution name). (Last Name) is (enter important contributions to invention and innovation, field of research, area of leadership, etc.). He/she is the recipient of (name prestigious prizes, honors and awards). He/she holds (number) U.S. patents and (number) foreign patents that have been licensed to (number) companies. He/she is the founder of (startup companies). He/she has published (enter number of articles, books, book chapters) and serves as (editor-in-chief, editor, editorial board, etc.) for (peer-reviewed journals, etc.). (Last name) is a (member/Fellow) of (prestigious organizations such as National Academies, AAAS Fellow, etc.).
- Summary in 200 words or less of patents, licensing and commercialization activities
(Name, Suffix) holds (number) patents in the field of (name field/industry), (number) of which have been licensed. His/her most significant patents are (patent name(s)/number(s)/short description of patent(s) and significance). (Last name) has licensed his/her patent(s) to (company/government name(s)). (Name of patent and number) was licensed to (company/government), as well as (list all other licensed patents). (Last name) is involved in (industry name). He/she has started (number) of companies, and was instrumental in the commercialization of (product, technology, etc.).
- Summary in 200 words or less of impact on public welfare
Please describe in three to four sentences the nominees impact through his or her inventions on the public welfare and overall economic impact. This section should include how many jobs have been created, lives touched and/or significant contributions to the advancement of science.
- U.S. Patent number(s) of significance — maximum of 10
- Contact information for nominator
Attachments (submit online):
- Nominee’s full CV
- Letter of nomination (on letterhead, signed and scanned) from the Nominator containing evidence of the nominee’s outstanding contribution to / achievements in innovation, describing the nominee's work and why he or she should be elected as an NAI Fellow. No more than two (2) pages.
- Optional: Full List on patents
- Optional: Nominee’s biography
It is the Nominator's responsibility to ensure all materials are submitted by the deadline. Nominations missing any documentation or submitted after the deadline will not be considered. No exceptions will be made.