<p> CIC/SCI Canada Award Nomination Form </p><p>Submit your completed nomination package by e-mail in pdf format for the following awards: Canada Medal, International Award, Kalev Pugi Award, LeSueur Memorial Award, Purvis Memorial Award and Julia Levy Award</p><p>New  Update </p><p>Name of Award (optional)</p><p>Name of Nominee</p><p>Present Position</p><p>Address</p><p>Tel. No.</p><p>Fax No.</p><p>E-mail</p><p>Date of Nomination </p><p>NOMINATOR Name </p><p>Address</p><p>Tel. No</p><p>Fax No.</p><p>E-mail NOMINATION REQUIREMENTS</p><p>The nominator is responsible for assembling the material required and submitting it to the Director of Awards. Only the items requested and/or listed below will be made available to the Selection Committee. Ensure that the Nomination Form is complete. Nominations shall remain in force for three years, unless otherwise stated. Nominators are invited to update nominations during the three-year term, preferably by submitting a complete, revised pdf file.</p><p>Citation (maximum one page) Provide a brief statement (approximately 250 words) of why the candidate should receive the award. This is the key document in the nomination and this information should be relevant to the Terms of Reference of the award in question, i.e. the achievements for which the award is being offered.</p><p>Biographical Sketch (maximum one page) This provides background information on the nominee and summarizes past accomplishments. This is a summary of information obtained from a C.V.</p><p>Curriculum Vitae and other Pertinent Information An abbreviated C.V. no more than nine pages is required. The C.V. should include education (institution, degree or diploma and year received; field; other specialized training); a record of employment in chronological order; background information on previous awards, prizes and fellowships and plenary lectures at national and international meetings; CIC activities and other pertinent information. Other pertinent information should include only the most relevant and significant publications, patents, inventions, professional activities, etc., on which the nomination is based. Supporting Letters (3 to 5) It is suggested that that a minimum of three and a maximum of five letters of support be included. At least two must be from outside the nominee’s organization. </p><p>Suggested information to include in letter:  state your relationship to the nominee, how long you’ve known that individual and your connection with him/her.  outline the achievements of the nominee: what did he/she accomplish, when, where and the outcome.  speak to the character of the nominee: leadership qualities, outreach to the community, etc,  other personal information you deem important for this award.</p><p>The following have sent or are sending letters of support and can be contacted for additional information.</p><p>Name Address Tel. No./E-mail address</p><p>1</p><p>2.</p><p>3.</p><p>4.</p><p>5.</p><p>The CIC/SCI Canada would like to acknowledge outstanding work carried out in the chemical community to superiors as well as to the general public. In the event that your candidate is chosen for the award, provide the following information:</p><p>Candidate’s supervisor Name</p><p>Address (if different from applicants) Local Media Contacts Proved a fax or e-mail address if possible 1.</p><p>2.</p><p>3.</p><p>4.</p><p>5. </p>