Nominees Must:

1. Have personal characteristics demonstrating a passion for excellence, concern for humanity, gritty determination and a broad vision.

2. Have produced creative work that has an enduring and meaningful impact and is replicable.

3. Be actively working in their field(s) so that this award will enhance their potential for future societal contribution.

4. Be U.S. citizens.

Note: Please do not nominate family members or individuals with whom you have a direct working relationship within your organization or elected or appointed public officials. Highest consideration will be given to those individuals who have not been overly recognized previously.

Nominations for the 18th Annual HEINZ AWARDS must be received no later than January 12, 2012.
1. NOMINEE
Name Title First Last Suffix
Title
Organization
Web Site
Business Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business Telephone:
Business Email:
Home Address (if available):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Telephone:
Home Email:
2. CATEGORY

We ask that you select a category, or categories, which best represents your nominee’s field.
Arts and Humanities Environment Human Condition Public Policy Technology, the Economy and Employment
3. BACKGROUND INFORMATION

Attach a short description of why you have nominated this candidate and the significance of the nominee’s work. No longer than one page, please.
You may enter information here or attach a document below.
Attach a File

Any text document or PDF may be attached here:
4. REFERENCES

Please provide us with the names of two references who know the nominee and/or are familiar with the nominee’s accomplishments.
Reference 1 Name: Title First Last Suffix
Reference 1 Title:
Reference 1 Organization/Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Reference 1 Telephone:
Reference 1 Email:
Reference 2 Name: Title First Last Suffix
Reference 2 Title:
Reference 2 Organization/Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Reference 2 Telephone:
Reference 2 Email:
5. ADDITIONAL MATERIALS

If available, please attach a copy of the nominee’s curriculum vitae or resumé and any other information that might help us in our evaluation.
You may enter information here or attach up to two documents below.
Attach a File

Any text document or PDF may be attached here:
Attach a File

Any text document or PDF may be attached here:
6. YOUR INFORMATION

Please enter your name, title, and contact information below:
Name: Title First Last Suffix
Title:
Organization:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Telephone:
Email:
To submit additional materials by regular mail:

The Heinz Awards
625 Liberty Avenue
Suite 3200
Pittsburgh, PA 15222
To call or fax us:

412 497 5775 (office)
412 497 5790 (fax)
NOTE: You may also download a copy of the Nomination Criteria and Form in PDF format here:
18th Annual Heinz Awards Nomination Criteria and Form.pdf
Do Not Fill This Out

The Heinz Awards

1. NOMINEE

2. CATEGORY

3. BACKGROUND INFORMATION

4. REFERENCES

5. ADDITIONAL MATERIALS

6. YOUR INFORMATION

To submit additional materials by regular mail:

To call or fax us: