RAN Distinguished Contributor Award Nomination Form

RAN Distinguished Contributor Award Nomination Form
Thank you for submitting a nomination for the RAN Distinguished Contributor Award. This award recognizes individuals who have demonstrated exceptional commitment, leadership, and impact within the Rheumatology Access Network (RAN) community.
Please complete all required fields and upload the requested supporting materials.
Submission Deadline: August 4th, 2026

Nominator Information
Full Name

First NameLast Name
Email Address
Phone Number
Optional. Please provide a phone number if available.Format: (000) 000-0000.
Organization / Employer
Are you nominating yourself?
Relationship to the Nominee
(If nominating yourself, please disregard.)

Nominee Information
Nominee Full Name

First NameLast Name
Nominee Email Address
Nominee Phone Number
Optional. Please provide a phone number if available.Format: (000) 000-0000.
Current Position / Job Title
Organization / Employer

Resume / CV Upload

(Maximum three pages)
Please submit a current CV or resume highlighting relevant experience and accomplishments.
Upload files below.

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RAN Involvement History
Please provide a summary of the nominee's involvement with RAN, including:
- Roles held (e.g., ambassador, volunteer, committee member, leadership positions)
- Timeline of participation, including start date and key milestones
- Programs, initiatives, or events supported or led
- Notable contributions to the RAN community
Enter RAN involvement history below.

Impact Statement

(Maximum 500 words)
Please describe the nominee's contributions and impact within RAN. Your response should address:

Leadership and Contributions
- Roles, projects, initiatives, or programs led or supported
- Unique skills, expertise, or resources contributed
Impact on the Organization
- Advancement of RAN programs, services, or strategic priorities
- Contributions to the growth and strength of the RAN community
Impact on Members and the Community
- Effects on members or the broader rheumatology community
- Measurable outcomes or lasting benefits
Commitment and Engagement
- Sustained involvement over time
- Contributions toward advancing RAN's mission and long-term goals
Please provide specific examples and measurable results whenever possible.
Enter your impact statement below.

Supporting Letters
Please upload Supporting Letters (Optional but Encouraged)

Optional supporting materials may include:
- Letters of support from RAN members
- Testimonials from colleagues, mentors, or community leaders
- Additional documentation demonstrating the nominee's impact and contributions
Upload files below.

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Additional Comments
Please provide any additional information you would like the review committee to consider, if applicable.
Should be Empty: