2020 Vilcek-Gold Award for Humanism in Healthcare Nomination Form

The Vilcek-Gold Award for Humanism in Healthcare was created jointly by The Arnold P. Gold Foundation and The Vilcek Foundation in 2019 to recognize a foreign-born individual who has had a demonstrable impact on humanism in healthcare through their professional achievements in the United States. This award marks the first humanism-in-healthcare focused honor for the Vilcek Foundation and the first immigrant-designated humanism honor for the Gold Foundation.

Nominee must be a naturalized citizen or permanent resident (green card holder) of the United States; be a holder of an H-1B or O-1 visa and have been living and working in the United States for at least 5 years; or have been granted Deferred Action for Childhood Arrivals (DACA). For questions regarding immigration standing, please contact Julia Lo, programs manager at the Vilcek Foundation at julia.lo@vilcek.org.

Fields marked with an * are required

Nominator's Information:

Nominee Information:

Has the nominee been notified of this nomination?

If your nomination is selected as a finalist, the nominee will be required to show proof of their eligible immigration status by submitting a copy of one of the following documents:


  • U.S. Passport (Nominee is a naturalized citizen)

  • U.S. Green card (Nominee is a permanent resident)

  • H-1B or O-1 Visa (Nominee has a valid  H-1B or O-1 Visa and has been living and working in the United States for at least 5 years)

  • Deferred Action for Childhood Arrivals (DACA) (Nominee is a DACA recipient)


Please confirm that the nominee has one of these documents to the best of your knowledge*:

 


Tell us about the nominee and your relationship to the nominee (1,500 words):

 

Describe the nominee's work (500 words):

 

Describe the humanistic impact of the nominee's work (500 words):

 

Please upload nominee's CV or resume as a PDF:

 

 

Please let us know where you learned of this nomination opportunity: