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ORISE Future of Science Awards

Mentor Nomination Form 2024

Thank you for nominating an ORISE Mentor for an ORISE Future of Science award. This prestigious award celebrates excellence in the mentorship of ORISE participants.

To be eligible, the nominee must have been an active ORISE mentor for at least one day within the period of August 1, 2023, through July 31, 2024. Please complete this form and submit by the deadline of 4:00 PM Eastern Time, July 26, 2024, for your mentor to be considered.

Please provide your information:*
Your full name
Your email address
Your telephone number (include area code)
Please provide the information for the nominee:*
Mentor first name
Mentor last name
Mentor email address
How long have you known the ORISE mentor you are nominating for an award?*
5989258223784cc38d380b05b0a7b8fd Less than 1 year 
5989258223784cc38d380b05b0a7b8fd 1-2 years 
5989258223784cc38d380b05b0a7b8fd 3-5 years 
5989258223784cc38d380b05b0a7b8fd More than 5 years 
What is your relationship/association with the ORISE mentor you are nominating for an award?*
5989258223784cc38d380b05b0a7b8fd ORISE Program Participant 
5989258223784cc38d380b05b0a7b8fd ORISE Program Coordinator/Federal Agency Staff 
5989258223784cc38d380b05b0a7b8fd Other 
Please provide the title/position of the nominee (e.g. Health Scientist, Research Ecologist, Mechanical Engineer):*
On a sliding scale from 1-10, with 1 being very low, 5 being average, and 10 being very high, rate the strength of the Mentor Nominee in the following areas:
If you have no basis for judgement for a specific area below, please select N/A.
Professional integrity
  • 1 
Fostering independence
  • 1 
Promoting professional development
  • 1 
STEM career planning/development
  • 1 
Ability to assess participant needs and provide direction/guidance
  • 1 
Open to and available for regular engagement
  • 1 
Ability to provide constructive criticism and feedback
  • 1 
Subject matter/professional expertise
  • 1 
Leadership skills
  • 1 
Please provide one or two distinct and meaningful examples for each of the following areas.*
In your response, please use complete sentences to draft thoughtful, detailed reflections that highlight the excellence of the nominee.

Contributions to Participant Experience:

  • For example, describe how the mentor facilitated open communication, offered support and encouragement, demonstrated accessibility and adaptability, fostered a positive mentoring relationship.

Encourages Personal and Professional Growth:

  • For example, describe how the mentor provided opportunities for participant growth and development, encouraged questions and creativity, provided constructive feedback, challenged participants to extend their abilities.

Evidence of Impactful Mentorship:

  • For example, describe how the mentor created engaging and meaningful projects, helped establish career and learning goals, provided professional and educational guidance, contributed to a productive educational experience.