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[Award
Application]
[Instructions/Guidelines PDF]
Application Deadline: January 31, 2012
Introduction/Intent of the Award
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:
- Are employed in the industry sector of the light energy or related technology enterprise and/or who have worked with light energy or related technology companies on innovation projects.
- Are at an early stage in their light energy and/or related technology career and/or professional development.
- Have demonstrated a strong work ethic.
- Display a potential for independent contribution and innovation.
The intent of this award is to recognize and encourage the development of future technology innovators and leaders and to inspire their continued professional development. The Award founders encourage the recipient to use the Award to further their professional development.
Eligibility
Any individual who is at an early stage of career and/or professional development is eligible to be nominated and/or apply for the Dr. Horace Furumoto Innovations Professional Development Award. Nominations/applications of non-clinical professionals particularly those who work in industry are especially encouraged and will receive special consideration. 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. 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 intended purpose of the award, the recipient is encouraged to apply the cash award to a professional development activity.
General Nomination/Application Instructions
Nominators and/or applicants must submit the on-line form and all supporting materials January 31, 2012. 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 2012 ASLMS Annual Conference. Recipients of the award will be notified in advance of the 2012 ASLMS Annual Conference and are requested to attend, if possible.
Nomination/Application Instructions
Purpose and Intent of the Award
The purpose of this award is to encourage the continued development of individuals interested in light energy and related technologies who are in the early stages of their career and/or professional development by recognizing their:
- Demonstrated work ethic.
- Potential for independent contribution.
- Potential for leadership and innovation.
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 Email, 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 work ethic, potential for independent contribution and potential for leadership and innovation by citing accomplishments to date and/or describing future potential. Examples may include but are not limited to:
- Past industry and academic experiences which demonstrate the individual innovation aptitude.
- Past innovative and independent technological work as a researcher, employee, or clinician.
- Outstanding leadership within their company and/or academic work with company(ies), independent contributions, 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 founders of the Dr. Horace Furumoto Innovations Professional Development Award encourage the recipient to use the cash award to further recipient’s professional development. While not a requirement of an Application/Nomination, individuals may wish to include a description of their intended use of the cash award.
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 the ASLMS Awards Committee with evaluation the individual’s past professional experience and development.
Revised 8/1/11
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
ASLMS Central Office
2100 Stewart Avenue, Suite 240
Wausau, WI 54401
Email: barb@aslms.org
Phone: (715) 845-9283
Toll Free: (877) 258-6028
Fax: (715) 848-2493
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