MDA Research Momentum Award Nomination Form
This award celebrates momentum—the drive, creativity, and collaboration that accelerate discovery and translate ideas into impact for people living with neuromuscular disease. Please complete and submit nomination no later than January 31, 2026, 11:59PM EST.
Winner must be willing to travel to the MDA Clinical & Scientific Conference - March 8-11, 2026
Nominator Full Name
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First Name
Last Name
Nominator Credentials (MD, PhD, etc)
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Nominator Title
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Nominator Affiliation/Institution
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Nominator Email
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example@example.com
Nominator Phone
Please enter a valid phone number.
Relationship to Nominee
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Colleague
Mentor
Collaborator
Self
Other
Nominee Full Name
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First Name
Last Name
Nominee Credentials (MD, PhD, etc.)
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Nominee Title
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Nominee Affiliation/Institution
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Nominee Email
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example@example.com
Nominee Phone
Please enter a valid phone number.
Year of First Independent Appointment
MDA Grant Recipient
Yes
No
Please describe how the nominee exemplifies the following: scientific innovation and originality; evidence of progress and leadership potential; and alignment with MDA’s mission and collaborative values. (max 500 words)
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Upload Nominee’s Current CV or NIH-style Biosketch (PDF) & Supporting Documents (publications, presentations, and/or posters)
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I confirm that the nominee is aware of this submission and has consented to be nominated.
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Yes
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