Please use Adobe Reader to complete the form. If you do not have Reader, it is a free download. Please download the form to your computer–do not fill it out in the preview.

The current nomination form is here: Download PDF Form

DEADLINE: Any Utah resident or organization may submit nominations, and all nominations must be received by 5 p.m. Wednesday, Dec. 19, 2018.

The Governor’s Medal award program was initiated to recognize those who have provided distinguished service or made significant career achievements that have benefited the state of Utah in the areas of science and technology. Nominees must have demonstrated important contributions in the fields of science, research, STEM education, or deep technology industry. Previous award recipients and current members of the medals review committee are not eligible for nomination. Nominations can be made in one of three categories:

  • Education – K-12
  • Academic/Research
  • Industry – Individual or Company

Contact – All requests for information should be sent to

Nominations may be emailed, mailed or UPLOADED BELOW:

  • Please upload completed nomination form and any additional documents (e.g., cover letter, cv, letters of support) that may help the review committee.
  • Drop files here or