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Nomination Form

EPA's BOSC Staff Office is seeking nominations of nationally and internationally recognized scientists, engineers, and social scientists to serve as Special Government Employees on a federal advisory committee to provide independent scientific and technical peer review, consultation, advice, and recommendations to the Office of Research of Research and Development (ORD). Interested persons or organizations may nominate qualified individuals or themselves by using the form below. To receive full consideration, nominations should include all of the information requested. Nomination period is open until April 1, 2013.

Persons with expertise related to ORD's research programs are needed to form subcommittees to support each of the six research programs (Air, Climate, and Energy Research Program; Safe and Sustainable Water Resources Research Program; Sustainable and Healthy Communities Research Program; Chemical Safety for Sustainability Research Program; Human Health Risk Assessment Research Program; and, Homeland Security Research Program).

The BOSC is a balanced and diverse expert committee. The committee and each of its subcommittees possess necessary domains of expertise, depth and breadth of knowledge, and diverse and balanced scientific perspectives. Selection criteria to be used for membership include: (a) Scientific and/or technical expertise, knowledge, and experience; (b) availability to serve and willingness to commit time to the committee (approximately two to four meetings per year including both face-to-face meetings and teleconferences); (c) absence of financial conflicts of interest; (d) absence of an appearance of a lack of impartiality; (e) skills working on committees and advisory panels; and (f) background and experiences that would contribute to the diversity of viewpoints on the committee/subcommittees, e.g., workforce sector, geographical location, social, cultural, and educational backgrounds, and professional affiliations.

EPA values and welcomes diversity. In an effort to obtain nominations of diverse candidates, EPA encourages nominations of women and men of all racial and ethnic groups.

Additional details regarding this request for nominations can be found in the Federal Register [Federal Register Volume 78, Number 24, Pages 8128-8129 (Tuesday, February 5, 2013)]. Please contact the BOSC Designated Federal Officer, Greg Susanke (susanke.greg@epa.gov ), if you have any questions or need assistance.

 
Self Nomination? Yes No
(If this is a self nomination please skip to # 2.)

1. Name of Person Making Nomination
First Name
Last Name
Suffix
(e.g., Ph.D., P.E., M.D., etc)
Affiliation
Email

2. Name of Nominee
First Name
Last Name
Suffix
(e.g., Ph.D., P.E., M.D., etc)
Professional Title
Department
School or Unit
University or Organization
Street Address
City
State
Zip Code
Phone
Fax
Email
Work Sector
Expertise
CTRL+click to select more than one area of expertise

Subcommittee Preference:
(Select ONE or MORE)

Air, Climate, and Energy Subcommittee
Chemical Safety for Substainability Subcommittee
Homeland Security Subcommittee
Human Health Risk Assessment Subcommittee
Safe and Sustainable Water Resources Subcommittee
Sustainable and Healthy Communities Subcommittee
Resume/CV
Provide a weblink to access the resume/CV or email the document to bosc@epa.gov

General BioSketch

Additional Information:
Additional information that would be useful for considering the nomination such as: background and qualifications (e.g., current position, educational background, expertise, research areas), experience relevant to one or more of ORD's research programs,service on advisory committees and professional societies, and availability to participate as a member of the committee/subcommittee.

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