2025 Merkin Prize

September 21, 2024
11:59 AM
Item - 2025 Merkin Prize Image-1 0
Unique ID
MP-2554
2025 Merkin Prize Nomination
Technology Name
asffas
List all nominators.
Please provide contact name for receiving Merkin Prize & Nomination related correspondence.
afs afs
Provide a summary that names the technology and indicates how it has improved human health. (Up to 50 words)
sgd
Briefly explain the novelty, purpose, and clinical impact of the nominated technology. (Up to 150 words)
sdg
Describe in detail the development of the nominated technology. (Up to 1000 words)
sgd
Describe in detail the past, current, and projected clinical impact of the nominated technology. (Up to 1000 words)
sgd
Describe in detail the substantive & quantifiable contributions of each nominated individual or team and how they played critical roles in the development of the technology and/or the application of the technology to improve human health, such as prevention, diagnosis, or treatment. (Up to 1000 words)
sgd
Nominee Information
Is this a self-nomination?
No
Is this an individu
al or team nominati
on?
Team
List the names, titles, affiliations, and research areas of up to 50 team members.
fsa
Article Citations
List the citations for up to ten articles that represent the work of the entire set of nominees and are central to the development or use of the nominated technology.
sgdgds
#1. Individual or team and why they were excluded from the list of the nominees. (Up to 100 words)
gsgddsg
Recommended Evaluators
Provide the names and emails of up to six knowledgeable individuals who could provide a critical evaluation of the prize-worthiness of the nominated technology, its clinical impact, and whether those nominated are the key contributors.
NameTitleOrganizationEmail
gsdgsdgdsdgs
How did you hear about the Merkin Prize?
Colleague
About this template
Categories
Details
6 Clone
Created by
merkinprize
Related templates
Sponsorship Proposal Template - PDF Templates

Sponsorship Proposal Template

This sponsorship proposal template helps you attract and convince your leads to be part of your event as a sponsor. It contains a front page, cover letter for the leads, company overview, information about the event and terms.

E-SignAgreement
Proforma Invoice Template - PDF Templates

Proforma Invoice Template

Speed up your sales process with this customizable Proforma Invoice PDF Template. Create professional pro forma invoices for buyers in minutes!

Proposal
Free Project Proposal Template - PDF Templates

Free Project Proposal Template

Need to write a project proposal? Get started with one of Jotform’s free project proposal templates here to save time and effort.

E-SignProposal
Grant Proposal - PDF Templates

Grant Proposal

Create a custom grand proposal in seconds. Easy to share and collect e-signatures. Works on any device. Drag and drop to customize. Streamline your workflow.

E-SignProposal
Consulting Proposal Template - PDF Templates

Consulting Proposal Template

Create a professional consulting proposal via Jotform Sign. Drag and drop to customize. Fill out and e-sign from any device. Easy to share. No coding.

E-SignProposal
Bid Proposal Template - PDF Templates

Bid Proposal Template

Create a bid proposal for upcoming projects. Customize the proposal to match your project’s theme. Works on any device — desktop, tablet, or mobile.

E-SignBusiness

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.