The Feigenbaum Medal Nomination Form
The Feigenbaum Medal is presented to an individual who is 35 years of age or younger (as of October 1 of applying year), who has
displayed outstanding characteristics of leadership, professionalism, and potential in the field of quality; and whose work has been, or
will become, of distinct benefit to mankind.
Award Criteria and Eligibility Requirements
The Feigenbaum Medal Committee may propose not more than one candidate each year. That candidate may be chosen by the Society
Awards Board based on a major single outstanding accomplishment, and/or several significant accomplishments in one or more areas
of activity. The Award recipient will receive this recognition only once in his/her lifetime. The recipient must demonstrate leadership
in the profession as well as Society work. No limitation is placed on who may receive the Feigenbaum Medal — ASQ member or
nonmember, graduate or non-graduate, engineer or manager, scientist or technologist or researcher, student or professor. The award’s
image is international and evaluation of candidates considers their contribution to quality namely regarding innovation (development,
application and publication of new concepts), promotion (training, presentations, teaching, etc.), application (professional activities,
implementations, consulting) and sponsoring (support to quality and other professional societies, public sector and not for profit
organizations, etc.).
The nomination form must be submitted as a Word file or pdf file by e-mail to the Committee Chair, as well as a paper copy sent by
mail (including a photo). You may attach additional pages, if necessary, but the nomination package is limited to a maximum of 12
pages. Avoid duplicating information or providing information in excess of that required to demonstrate the nominee’s qualifications.
Please submit the form and supporting documentation showing contributions to the quality profession to:
ASQ
Awards Administrator
600 N. Plankinton
Milwaukee, WI 53201
sgones@asq.org
THE DEADLINE FOR SUBMISSION IS OCTOBER 1
1. Date of Birth:
2.
Professional Society Membership(s).
3. Name of the person being nominated:
Tell us how you wish your name to appear on your award and in any mention of your election. Please note: For
consistency, ASQ does not use a prefix such as Dr. or any degrees or certifications such as Ph.D or CQE, etc.
4. To the best of your ability, provide a phonetic spelling of your name. This will assist us in announcing you at the
ASQ World Conference.
5.
Please provide us with the Company Name, City and State you want used in your press release. Eg. ASQ,
Milwaukee, WI
Company
City
State / Province
Nominees Contact Information:
Address:
City
State/Province
Postal Code
Country
Phone:
E-mail address:
6. Nominator
Information for contacting nominator:
Address:
City
State/Province
Postal Code
Country
Phone:
E-mail address:
Citation
Please write the citation as it will appear on the candidate’s award and certificate. The citation is the official commendation
of the applicant by ASQ and should reflect the applicant’s meritorious actions. Please limit the citation to no more than 40
words.
Evidence that the nominee made a major contribution to the field of quality (professional
accomplishments) and demonstrates leadership.
Show that nominee (1) has developed new techniques, innovative designs, and new research, (2) published books and patents,
or (3) otherwise made significant contributions to the field of quality. Such contributions may be the application of quality
methodologies in unique and innovative ways. Any of the following accomplishments should be mentioned in this section.
Honors and Recognitions Received:
Refereed Papers, Journal Articles, Books, Published Research (including dissertation), and Other Evidence of Scholarly
and/or Professional Work:
Patents:
Published Articles about the Nominee in Professional Magazines, Newspapers, Journals, etc.
Evidence that the Nominee made contributions to ASQ and/or professional societies. The
work is focused toward the field of quality.
Show how the nominee (1) has communicated his/her contributions through presentations at conferences, (2) has documented
demonstrations that the work helped the professional society significantly, and/or (3) has achieved major professional
accomplishments. Show what positions the nominee has held in the professional societies.
ASQ and/or Professional Society Activities, Including Positions:
Presentations or Public Lectures:
Major Professional Accomplishments Regarding the Application/Implementation of Quality Concepts in Private Companies
and/or Not for Profit Organizations:
References
These five references will be people who:
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Are not nominators.
Are not members of the Feigenbaum Medal Committee
Have direct knowledge of the nominee and his/her work.
Have agreed to be available for contact by the members of the Feigenbaum Medal Committee.
Can confirm and elaborate on one or more aspects of the nominee’s work and impact as described in the nomination.
1.
Printed Name:
Phone Number:
E-mail address:
2.
Printed Name:
Phone Number:
E-mail address:
3.
Printed Name:
Phone Number:
E-mail address:
4.
Printed Name:
Phone Number:
E-mail address:
5.
Printed Name:
Phone Number:
E-mail address:
Provide a short biographical summary of the candidate