Nomination Forms

Gamechanger Award Nomination Form*

To be awarded to the faculty member or researcher who invented the most impactful product introduced to the market.  The invention must have been translated into a new or improved technology, product or service which has been put into public use and has (a) improved societal well-being, (b) provided economic benefit to the region or state, and/or (c) advanced scientific understanding in their field.

Disruptive Research Award Nomination Form*

To be awarded to the faculty member or researcher who engaged in use-inspired research that has not yet been translated into real world applications but has demonstrated exceptional novelty and discovery with strong potential to be developed into new or improved technologies, products, and/or services that will improve lives.

Best Startup Award Nomination Form*

To be awarded to the faculty member or researcher who founded the best new company – utilizing UC research – that addresses societal needs.

Community Changemaker Award Nomination Form*

To be awarded to a private sector leader or organization that has contributed significantly to improving social and economic prosperity by supporting UC‘s innovation enterprise.

Distinguished Lifetime Achievement Award Nomination Form*

To be awarded to a faculty member or researcher whose career accomplishments include multiple innovations that have led to long-term positive impacts on the lives of others and is an inspiring influence for aspiring UC inventors and entrepreneurs.

*Please do not use these PDFs to submit a nomination. These sample nomination forms are publicly shared in the interest of transparency, allowing the UC community to view the evaluation criteria that will be used to determine the winners for each category. The official nomination forms have been transmitted to the offices of each campus chancellor and national laboratory director. 
 
Note that each campus/national lab shall submit only one nomination for each award. In determining the nominee, each campus/national lab has been empowered to develop its own nomination process, one that reflects its community’s unique culture and priorities. For more information about the Regents Innovation Award, click here for FAQs.