2013 Inductee Nomination Form

For nominations: Please fill out this form

The Long Island Technology Hall of Fame honors the contributions,
exceptional accomplishments, and dedication of historical figures or
current leaders who have had or are having an impact on Long Island
science and technology.



Nominating Party
Name
Company
Address
State
Zip
Phone
Fax
E-mail


Person Nominated
Name of Person Nominated
Company (if applicable)
Contact Number
Email
Address
City
State
Zip


Selection Criteria


Please provide a few sentences on why you are recommending this person for induction to the Long Island Technology Hall of Fame, according to EACH of the following selection criteria:
1. Impact on science and technology (inventions, patents, discoveries, etc.)

2. Lifetime Achievement (professional attainments, positions held, titles, etc.)

3.Contributions to Long Island’s economic development (companies started, impact LI industry, etc.)

4. National prominence
(government awards or honors, agency affiliations, etc.)

5. Academic attainment (degrees, fellowships, honorary societies, etc.)

6. Commitment to the Long Island community (length of residence, community service, investment, etc.)

 
Attach necessary supporting documentation, including a brief, typewritten biography (Limit of 500 words) Materials on individuals not selected for induction in a particular year will be held for future consideration
   

Send hard copy to Kathleen Ferrell, 127 Engineering, Stony Brook University, Stony Brook, NY 11794-2200 or FAX: (631) 632-8205 or e-mail: kathleen.ferrell@stonybrook.edu

Deadline for LITHF 2013
November 26, 2012

Selected inductees will be notified by December 10, 2012