Clive Callender, MD Circle of Excellence Award

Presented by:

Award Description:

The Clive Callender, MD Circle of Excellence Award honors a candidate from the African American, Asian American - Pacific Islander, Hispanic, or Native American community who has demonstrated exceptional leadership and made a meaningful impact within the field of organ, eye, and tissue donation or transplantation for communities of color. As a result of their leadership, they exemplify the highest level of professionalism and compassion, as demonstrated by Dr. Callender.

Award Criteria:

perseveres in the face of adversity
is known in the donation and transplantation community as a reliable, go-to person, willing volunteer in the organ, eye and tissue donation and transplantation community or good citizen (e.g. reaches out to new staff; motivates others; mentors) who enriches the importance of organ donation
implements change in a positive manner and strives to ensure its success
demonstrates ability to "stir the pot" for positive, fresh impact
approaches problem-solving with a solution orientation
inspires and encourages personal and professional development in others
builds strong relationships that support a high level of trust and credibility
promotes transfer of knowledge and influence from person to person
the nominee must be a clinical, volunteer, academia, donation or transplantation professional
self-nominations are not allowed

Nominee Information:

First Name *

Last Name *

Title *

Organization *

Email Address *

Phone *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Connection to donation/transplantation – check all that apply: *

Race or Ethnicity: *

How many years has the nominee been working in the donation or transplantation community? *

When responding to the items below, refer to the Award Criteria to ensure you have included statements, examples and descriptions that are effective in determininng your nominee's qualifications for this award.

Nominee Information:

Provide a statement, event(s) or action(s) that show the nominee's commitment to excellence in donation or transplantation. *

0/200 characters

Provide a statement that shows the nominee as a visionary (What program was /is being developed because of their grass roots efforts to improve donation or transplantation for communities of color?) *

0/200 characters

Describe and give examples of your nominee's willingness to volunteer in the organ, eye and tissue donation or transplantation community or how they are a good champion for the cause of donation and or transplantation, how they reach out to new staff; motivate others, mentor or enrich the importance of organ donation. *

0/500 characters

Please upload a photo(s) or video of the nominee. Photo requirements: high resolution jpg, tiff or png, maximum of 3 photos

Nominator Information:

First Name *

Last Name *

Title *

Organization *

Email Address *

Phone *

Street Address *

Address Line 2

City *

State *

Zip Code *

Relationship to Nominee *