AADPRT 2026 Annual Meeting Lifetime Service Award Nomination

AADPRT Lifetime Service Award Nomination Form

The prupose of the award is to acknowledge an AADPRT psychiatrist member who has had a singificant impact on psychiatric residency education nationally. The awardee will be honored with a plaque at the Annual Meeting.

Please complete the form below in its entirety including the upload of the nominee's CV (please title document with last name of nominee and the word CV, no punctuation) as well as your nomination letter (please title document with last name of nominee and the word letter, no punctuation).

Nominating Deadline: Wednesday, 9/17/25, 5pm ET

Submitter First Name (Must be current AADPRT member)*

First Name

Submitter Last Name (Must be current AADPRT member)*

Last Name

Submitter Email*

example@example.com

Submitter Institution (if applicable)

Nominee First Name*

First Name

Nominee Last Name*

Last Name

Nominee Email*

example@example.com

Nominee Institution*

Upload nomination letter (no longer than two pages), nominee's CV, and brief bio of nominee as one PDF*

PLEASE TITLE DOCUMENT "LIFETIME SERVICE NOMINEE LAST NAME DOCUMENTS" WITHOUT PUNCTUATION

Upload Head Shot of Nominee (jpeg preferred)*

PLEASE TITLE DOCUMENT "LIFETIME SERVICE NOMINEE LAST NAME HEAD SHOT" WITHOUT PUNCTUATION