Geiger Gibson Program Emerging Leader Awards Nomination Form

Please complete the form below to nominate a staff member from your community health center, primary care association (PCA), or health center controlled network (HCCN) for the Geiger Gibson Emerging Leader Award. Awardees will be recognized at the NACHC Policy & Issues Forum to be held in Washington, DC.

  • All nominations must be made by the Executive Director or CEO of the health center, PCA, or HCCN.
  • UPDATE -  Nominations  were due COB, Monday, November 20, 2023 and are now CLOSED.

BEFORE COMPLETING THE APPLICATION, PLEASE MAKE SURE THAT YOUR NOMINEE MEETS THE ELIGIBILITY REQUIREMENTS AND REVIEW THE SELECTION CRITERIA:

To be eligible for the Emerging Leader award, the nominee must meet all of the following requirements:

  • Is currently working at a community or farmworker health center, primary care association (PCA) or health center-controlled network (HCCN);
  • Has worked at the nominating health center, PCA or HCCN for at least one year;
  • Is not older than 35; and
  • Is not the Executive Director/CEO/President of the organization.

Award Selection Criteria:

The Emerging Leader award is designed to highlight and share the accomplishments of exceptional young colleagues working in the health center movement whether in a community health center, PCA, or HCCN. The awards celebrate young leaders whose specific work has helped further the health center mission of accessible, affordable health care and better health for medically underserved patients, communities, and special populations. We welcome nominations of staff in all positions, roles, and disciplines across the organization. The program considers the full range of health center/network/PCA activities, operations, and accomplishments, with particular emphasis on the following criteria:

  • The nominee’s work accomplishments do not simply fulfill their responsibilities, but go above and beyond what is expected, evidencing their leadership capabilities;
  • The nominee has lived experience that is reflective of the populations and communities served by the organization;
  • The nominee’s efforts are useful to and transferable to other health centers and help advance the overall status of health centers within the health care  system;
  • The nominee recognizes and demonstrates the “community” aspect of “community health center” through engagement and collaboration with other organizations and community members;
  • The nominee has displayed a sense of personal motivation by advancing within their organization in a short time and/or pursuing educational opportunities in a related field.
Please complete the following information about the nominee:
as of February 10, 2024
Organization Address
One file only.
256 MB limit.
Allowed types: pdf, doc, docx.
One file only.
256 MB limit.
Allowed types: jpg, png.
Please provide the following information about the nominator: