Nomination Form

Submit a Nomination

Please submit the form below no later than December 5th. For those not comfortable filling the form out electronically, click here for the fillable pdf.

Supplemental materials can be sent to rhstarawards@gmail.com

Nomination Categories

Environmental Improvement

Health and Medical

Disaster Relief and Recovery

Knowledge Sharing

Your Information

Your First Name (required)

Your Last Name (required)

Your Email Address (required)

Your Phone Number (required)

Information about Individual/Team Being Nominated

Name of Individual/Team Being Nominated

Phone Number of Individual/Team Being Nominated

Email Address of Individual/Team Being Nominated

Category of Humanitarian Benefit
Environmental ImprovementHealth and MedicalDisaster Relief and RecoveryKnowledge Sharing

Short Biography/Background of the Nominee

Project Name and Description

A summary of the specific scientific or technological accomplishment, discovery, or contribution. Please include links to relevant websites.

Humanitarian Benefit

Please describe the humanitarian benefit of the specific scientific or technological accomplishment, discovery, or contribution. Please include links to relevant websites.

Website