Finkelstein Award Nomination Form

Nominee's Name*:
Nominee's Role/Title*:
Nominee's Organization*:
Nominee's Email*:
Nominee's phone number*:	( ) - Second three digits Last four digits
Name*:	Name of person nominating an individual
Relationship to Nominee:	E.g. Patient
Organization*:	Organization of person nominating an individual
Email*:	Email of person nominating an individual
Phone number*:	( ) - Second three digits Last four digits Phone number of person nominating an individual
Nominee’s impact on Crohn’s and colitis research, practice and policy*:	The nominee is a person who has made an outstanding contribution to the field of Crohn’s and colitis. I believe that this contribution is "outstanding" because of the above accomplishment or continuous efforts: (200 character maximum)
Additional Information*:	I recommend that the Awards Committee also consider the following factors in judging the merit of this nomination: (200 characters max)
Upload support file 1:	Please upload any information you believe will be of assistance to the Selection Panel as it considers this nomination. If you have any additional supporting materials (e.g. letters of support), you may attach them as a pdf document here.
Upload support file 2:	Please upload any information you believe will be of assistance to the Selection Panel as it considers this nomination. If you have any additional supporting materials (e.g. letters of support), you may attach them as a pdf document here.

Canada has among the highest incidence rates of Crohn's and colitis in the world.
1 in 140 Canadians lives with Crohn’s or colitis.
Families new to Canada are developing these diseases for the first time.
Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
People are most commonly diagnosed before age 30.

Finkelstein Award