2018 Leonard Heise Award Nomination Form

The EBAA Heise Committee is accepting nominations for the 2018 Leonard Heise Award. The Leonard Heise Award is presented to a non-physician eye banker recognized for his/her outstanding devotion to the EBAA’s mission and development, and for exemplifying the precepts of Leonard Heise, a major contributor to the fight against corneal blindness and one of the EBAA’s founders.

Nominations for the award must meet the following requirements:

  • Nominee must have been associated with an EBAA accredited eye bank for at least 10 years.
  • Nominee must have made significant contributions to eye banking at a national and/or international level, as well as at a local level.
  • The nomination must be supported by at least one of the following from the nominee’s eye bank: Board President, Executive Director and/or Medical Director.
  • Individual’s local, national and international contributions to the EBAA and eye banking must be noted in the nomination.

Since nominees are not always well known to members of the Heise Committee, decisions may be made based on contributions as detailed in the material submitted. Comprehensive information that outlines a nominee’s contributions is helpful. All nominations will be reviewed by the Heise Committee, made up of previous Heise Awardees.

To re-nominate an individual whom you nominated in the past, please send an updated letter of support for that individual from the Executive Director, Medical Director or Board President of his/her eye bank to Stacey Gardner at Stacey@restoresight.org.

Nomination Deadline: Monday, October 2, 2017.

Heise Nomination Form

  • Nominator's Name & Information

  • Nominee's Information

  • Nomination Information & Nominee's Contributions to Eye Banking

  • Please state why this individual should receive the EBAA Leonard Heise Award.:
  • What contributions has this individual made to eye banking on the local level? (Nominees must demonstrate a positive influence, representing eye banking in his/her local eye bank area by working collaboratively with other organizations or at a community level):
  • What contributions has this individual made to eye banking on the national or international level? (Ex. Serving as a member of the Board of Directors of the EBAA or as chair of an EBAA committee, as well as volunteer services that enhance the mission of the national association.):
  • Please use this space for any additional comments that you would like to add about the nominee: If applicable, please enter the names of others who are in support of this nomination. (Please include job titles, relationship to the eye bank, and email addresses.):
  • Document Upload

  • Please include a resume/CV for the Nominee.
    Drop files here or
    Accepted file types: jpg, pdf, doc, png, gif, docx.
  • Additional letters/documents in support of the nomination.
    Drop files here or
    Accepted file types: jpg, pdf, doc, png, gif, docx.