Community Service to Research Nomination Form

You have selected an option that triggers this survey to end right now.

The Community Service to Research award seeks to recognize the important contributions of community members, health practitioners, public leaders, and community groups that have demonstrated an established record or service to the UNMC research enterprise.

Nominees cannot be employed by UNMC or the University of Nebraska.
Nominators must be a UNMC faculty member.
Deadline for nominations is July 24, 2026.

Please direct any questions about the award or nominations process to the Office of the Vice Chancellor for Research (research@unmc.edu).

Survey Date

M-D-Y

Please provide the following information about the individual you are nominating for this award:


	Name:			Organization: (if applicable)

	Email:			Position/Role:

	Phone: (optional)			Link to Bio/Website: (optional)

Please provide your contact information:

As part of your nomination, please upload a letter of support by clicking "Upload File" below.

The letter should briefly state:
- the nominator's relationship to the nominee,
- how the nominee has contributed to the UNMC research enterprise, and
- why you believe this individual or group is deserving of recognition.
If there are multiple nominators, please combine letters of support from each nominator into a single PDF before uploading. Additional letters of support may come from UNMC faculty, staff, alumni, or students.
Please limit letters to 500 words or fewer.

College/Unit:

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.