2016 FLC ROOKIE OF THE YEAR AWARD NOMINATION FORM

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1 2016 FLC ROOKIE OF THE YEAR AWARD NOMINATION FORM

2 ***** SUBMISSION DEADLINE: OCTOBER 30, 2015 ***** 2016 FLC Rookie of the Year Award Nomination Form The FLC Rookie of the Year Award recognizes the efforts of an FLC laboratory technology transfer professional who has demonstrated outstanding work in the field of technology transfer in a manner significantly over and above what was called for in the normal course of their work during the past year. The nominee must be new to technology transfer with three years (or less) experience in a technology transfer position.* USE THIS FORM ONLY NOT LAST YEAR S TO SUBMIT YOUR NOMINATION. PLEASE READ CAREFULLY TO AVOID HAVING YOUR SUBMISSION DISQUALIFIED. Award Criteria Nominees of the 2016 FLC Rookie of the Year Award will be judged on the following criteria: 1. The Nominee must have demonstrated exceptional service performing their technology transfer professional responsibilities within their organization over the past year. 2. The nomination must provide a clear explanation of the innovative approach or creativity to addressing a need and demonstrable results. 3. The nomination must describe the specific roles, goals, objectives and contributions of the nominee. 4. The nomination must describe what has been the impact to date and how that impact is determined. 5. The nomination must indicate nominee s first date of employ in a technology transfer capacity (either within or outside of federal employment and not just the date of the current position). *Technology Transfer fellows are eligible to receive this award. The three-year period in this instance begins upon acceptance of the fellowship position. Submission Guidelines Nominee must work in direct support of an FLC laboratory. Nomination narrative should not exceed three pages. Use Arial or Times font styles that are no smaller than 12 points. I 2016 FLC Ro o kie of the Year Award

3 ***** SUBMISSION DEADLINE: OCTOBER 30, 2015 ***** Do not attach supporting documentation (e.g. brochures, newspaper articles, press releases). Do not include links to websites, homepages, etc. The complete nomination form (Section A, B, and C) must be sent electronically to the FLC Management Support Office at Assistance Contact Michele Chambers of the FLC Management Support Office at (856) , if you require assistance in submitting your nomination. Submission Deadline Both the Nomination form and Submission Verification form must be received by the FLC Management Support Office by 8:00 p.m. EDT (5:00 p.m. PDT) on Friday, October 30, No submissions will be accepted after this time. Announcement of Results The winner of the 2016 FLC Rookie of the Year Award will be announced in January Laboratories submitting nominations will be notified prior to the official announcement. Award Presentation The winner will be honored at the 2016 FLC National Meeting in Chicago, Illinois in April Award Publication The FLC will publish a commemorative publication highlighting the accomplishments of the winners that will be distributed at the National Meeting. Winners will be asked to provide electronic photos for inclusion in the publication. Individual or group photos in a.tif or.jpeg PC computer file with a minimum 300 dpi resolution should be provided. If sending a group photo a caption must be included. II 2016 FLC Ro o kie of the Year Award

4 FOR FLC USE ONLY DO NOT COMPLETE OR REMOVE RECEIVED: SUBMISSION NUMBER: 2016 FLC Rookie of the Year Award Section A Contact Information NOMINATOR INFORMATION Name: Title: Organization: Address: City: State: Zip: Phone: NOMINEE INFORMATION Name: Title: Organization: Address: City: State: Zip: Phone: A FLC Rookie of t he Ye ar Award

5 2016 FLC Rookie of the Year Award Section B Nomination Narrative B FLC Ro o kie o f t he Ye a r Award

6 B FLC Ro o kie o f t he Ye a r Award

7 B FLC Ro o kie o f t he Ye a r Award

8 2016 FLC Rookie of the Year Award Section C Submission Verification NOMINEE: NOMINATOR INFORMATION: Name: Title: Laboratory: Address: Phone: By typing my name below, I, the nominating FLC Laboratory Representative/FLC Agency Representative, I understand that entries not conforming to eligibility requirements and/or criteria will be returned without consideration. Nominator: Date: C FLC Ro o kie of the Year Award

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