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[Award
Application]
Deadline:
January 31, 2010
Introduction
The ASLMS is very pleased to administer the annual Dr. Horace Furumoto Innovations Professional Development Award. This award was founded by Candela Corporation, Cynosure, and DEKA to memorialize the genius, leadership, and commitment of Dr. Horace Furumoto. These firms have joined together to create an endowment which annually may award up to $10,000 to an individual(s) who displays the potential for leadership and innovation characterized by Dr. Furumoto.
The purpose of this award is to foster future technology innovators and leaders, and to inspire their continued professional development through financial assistance. It is the expectation of the sponsors, that the recipient will use the award to further their professional development through continuing education. The Dr. Horace Furumoto Innovations award recipient(s) will demonstrate the potential for leadership and technology innovation as described by the following:
Eligibility
Any individual is eligible to be nominated and/or apply for the Dr. Horace Furumoto Innovations Professional Development Award. Nominations/applications of non-clinical professionals are especially encouraged. Successful nominees/applicants will have demonstrated an interest in and or experience with the innovative application of light emitting devices or related technology in health care. All nominators and/or applicants are required to complete and submit the Dr. Horace Furumoto Nomination/Application Form. Consistent with the purpose of the award, individuals being nominated and/or applying for the award must, as part of the nomination/application process, describe in general terms their plans for continuing their professional development. The ASLMS Awards Committee is charged with annually selecting an award recipient(s). ASLMS reserves the right not to select any of the nominees/applicants as recipients, or to select more than one award recipient in any given year based upon the recommendations of the ASLMS Awards Committee.
Applying the Award to Professional Development
Consistent with the purpose of the award, the recipient is expected to apply the award to a professional development activity as described in their nomination/application within twelve (12) months of the award announcement. Expenditure of the award may extend beyond a one year period but should not exceed three (3) years.
General Nomination/Application Instructions
Nominators and/or applicants must submit the on-line form and all supporting materials no later that January 31st, of the year for which they are nominated/applying for the award. An application form is located in the Research Grants/Awards section of the ASLMS Web site. Each nomination/application requires two letters of support. The individual(s) who is nominating a candidate may author and submit a letter(s) of support for the candidate they nominate. Letters of support on official letterhead of the author’s organization are to be emailed, faxed, or mailed under separate cover to Barb Brown at the ASLMS Central Office, barb@aslms.org. The award recipient will be officially announced at the ASLMS Annual Conference. Recipients of the award will be notified in advance of the ASLMS Annual Conference and are requested to attend, if possible.
Dr. Horace Furumoto Innovations
Professional Development Award
Nomination/Application Instructions
SECTION I. Demographic Information
This section of the form requests information about the nominee/applicant and nominator. This information will be used to contact individuals if additional information is required, and/or to assure the ASLMS Awards Committee of the appropriateness of the nomination/application.
SECTION II. Letters of Support
Two letters of support are required for each nominee/applicant. In instances where an individual is being nominated, the nominator may write one of the letters of support for the candidate. Letters of support should come from individuals familiar with the nominee’s/applicant’s professional and/or academic work. Letters should discuss the individual’s leadership and technological innovation potential. Examples of past leadership and/or technology innovation should be cited. Letters of support must be submitted either by e-mail, fax, or mail on official letterhead of the author’s organization to the attention of Barb Brown of the ASLMS Central Office, barb@aslms.org.
SECTION III. Description of Nominee/Applicant Qualifications (Maximum of 2 pages)
This section of the form is to be used to describe to the ASLMS Awards Committee current and past examples of the nominee’s/applicant’s professional and academic work which demonstrate the individual’s leadership and or technological accomplishments to date and/or future potential. Examples may include but are not limited to:
- Past academic and professional experiences which have prepared the candidate to successfully complete the professional development activities described in the professional development plan included as part of this nomination/application form.
- Past innovative technological work as a researcher, employee, or practitioner.
- Outstanding academic, leadership and/or innovation accomplishments.
- Recognitions received from employers, peers, or professional organizations.
- Authorship of manuscripts and/or publications which represent innovative ideas, and/or approaches to the application of laser and related technologies.
- Leadership positions held in organizations dedicated to technological innovation.
SECTION IV. Nominee/Applicant Professional Development Plan (Maximum of 2 pages)
The purpose of the Dr. Horace Furumoto Innovations Professional Development Award is to support the professional development of individuals assessed to have the potential for leadership in laser and related technology innovation. To that end, it is very important that nominees/applicants have a well developed professional development plan. Traditional and non-traditional professional development concepts are encouraged. While traditional academic continuing professional development activities are acceptable, innovative approaches to developing one’s professional preparedness are also encouraged, as they may represent evidence of the nominee’s/applicant’s potential for innovation. If the nominee/applicant intends to participate in a formal academic program, written evidence of the acceptance into a formal education program is required prior to the distribution of the grant. Similarly if the intent is to pursue a less traditional professional development activity, a commitment of the host organization/individual providing informal professional development will be required prior to the actual provision of the grant.
Professional development plans may take many forms including but not limited to:
- Academic study at a University.
- Mentorship(s) with an individual(s) working on technologic innovation.
- Special research project(s) focused on technological innovation and which provide the nominee/applicant with a professional development experience.
- Sabbatical leave for the purpose of dedicating time to increase the individual’s professional preparedness.
- Participation in an internship either business and/or clinical which focuses on leadership and/or technological innovation.
- Clinical and/or research preceptorship which focuses on technological innovation.
- Fellowship program.
Section V. Nominee/Applicant Resume (Maximum of 2 Pages)
The nominee/applicant is required to provide a formal (condensed) resume in the space provided on the form. The purpose of the resume is to assist with determining if the candidate is properly prepared to participate in the professional development plan activities which they have proposed, and to assist the ASLMS Awards Committee with evaluating the individual’s past professional development.
No grant will be awarded to any person if the award would be contrary to any United States law, including but not limited to trade embargoes administered by the U.S. Treasury Department’s Office of Foreign Assets Control.
Questions related to the nomination/application form can be directed to:
Barb Brown, Program and Services Coordinator
barb@aslms.org
ASLMS Central Office
2100 Stewart Avenue, Suite 240
Wausau, WI 54401
Phone: (715) 845-9283
Fax: (715) 848-2493 |
