US NAM Healthy Longevity Catalyst Award Competition Reviewer Nominations Form

The National Academy of Medicine's (NAM) Healthy Longevity Global Competition is a multi-year, multi-million dollar competition to stimulate innovation and transform the field of healthy longevity globally. In the first phase of the Global Competition, Catalyst Awards will reward bold, new, potentially transformative ideas—originating from any field or combination of fields (e.g., biomedicine, behavioral science, sociology, engineering and infrastructure, technology, and policy)—to improve the physical, mental, or social well-being for people as they age. Catalyst Awards are intended as seed funding to help innovators advance their ideas. Following a very successful Round 1, the NAM is gearing up to administer Round 2 during the first half of 2021.

The NAM seeks to assemble a broad and diverse pool of "Innovation Reviewers," including luminaries and experts from across the health, medical, biological, and social sciences, as well as business leaders and thought leaders from across the disciplines. Ideal reviewers will be broad, “out-of-box” thinkers with a history of innovative thinking.

Please complete the following form to nominate someone for consideration as an Innovation Reviewer for the 2021 US NAM Catalyst Award competition. You may also nominate yourself.

The NAM will make efforts to ensure the review task is not overly burdensome for any individual reviewer. The applicants are just two-pages long, and the review task does not involve extensive written commentary or completion of a lengthy scoring rubric.

1. Nomination Submitted By: *This question is required.

First Name *This question is required.

Last Name *This question is required.

Job Title *This question is required.

Affiliation *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

3. Nominee Contact Information: *This question is required.

First Name *This question is required.

Last Name *This question is required.

Job Title *This question is required.

Affiliation *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

3. Link to Nominee's Website or Biography:

4. Upload Nominee's Biography

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5. In your own words, please summarize the nominee's area(s) of expertise or interest: