Nominate for the Bergmann Medal

Only nominations submitted by the nomination deadline (June 30) will be considered for the Bergmann Medal in the same year. Nominations submitted after the deadline will be considered in the following year. Submissions must be filled out in their entirety and cannot be accessed again.

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Nominator Name^*

First

Last

Email^*

Phone^*

Address^*

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Is the Nominator an RCGS Fellow?^*

Yes

Nominator Details^*

Brief description of nominator including relationship to nominee

Nominee Name^*

First

Last

Email^*

Phone^*

Address^*

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

A two-page (maximum) nomination letter

No file chosen

Specifically describing the nominee’s accomplishments in relation to the mandatory criteria of collaboration supplemented by the other categories noted above, to justify why the individual is worthy of the Martin Bergmann Medal.

Abridged CV of Nominee

No file chosen

Please upload an abridged version of the nominee's curriculum vitae, including selected publications, films or other achievements. A strictly enforced total maximum of ten (10) pages is available for CV, publications, etc.

Additional letters of support (strongly recommended)

Drop files here or

Up to four additional one-page letters of support for particular aspects of the nominee's achievements may be uploaded.

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