Nomination Instructions
The individual completing this application and submitting the supporting documentation is considered the primary endorser. This person is responsible for compiling and submitting all materials included in the nomination package.
Application Components:
- A brief summary
- Copy of current Resume/CV
- One letter of support from a current or past employer's department head or hospital adminstration.
In addition to the application materials listed above, the nominator/applicant must also identify two additional endorsers who will each complete the below online endorsement form.
Please copy and paste the appropriate link and send it directly to each of your endorsers. Once they fill out the form and click Submit, no further action is required—the form will automatically be included with your application for review by the Awards Committee.
- Please copy and paste this link, https://form.jotform.com/252797127550160 and send to each of your endorsers. Once they complete filling out the endorsement form, they simply click submit and it will be sent to the Awards Committee to be included with this application.
⚠️ Important: To maintain the integrity of the review process, please do not include the nominee’s name or any other identifying information (such as workplace, city, or specific program names) in your responses. The Awards Committee reviews applications in a blinded format, and inclusion of identifying details may affect eligibility.
If you have any questions, please contact the Awards Committee for assistance.
Please note you will need to submit ALL documentation by 11:59 pm, EST, Monday, December 1, 2025.