PSRC Lifetime Achievement Award Nomination Form

The PSRC is seeking nominations for the 2024 PSRC Lifetime Achievement Award. This award honors a member who has best demonstrated throughout their career the qualities of excellence, compassion, collaboration, volunteerism, and extreme competence to the field of Respiratory Care.

In order to be eligible for nomination, the nominee must meet the following criteria:

1) Nominee must have maintained AARC / PSRC membership for a period of at least twenty (20) years or longer.

2) The nominee must have a demonstrated relationship to the field of Respiratory Care for a period of at least 25 years or longer during their career.

3) The nominee must have demonstrated a significant contribution to the PSRC during their career. Examples of significant contribution include serving as a member of the PSRC Board of Directors and/or serving as a member or chair of one or more PSRC committees.

(Note: Members may be nominated posthumously.)

Additionally, consideration should be given to the following:

a. Excellent clinical and communication skills

b. Commitment and Dedication to the profession

c. Excellence and commitment to the care of patients affected
by pulmonary diseases

d. Professionalism

e. Compassion

f. Promotes teamwork and collaboration in the field of Respiratory Care

g. Serves as a mentor to both colleagues and students-is often a resource to members of the Respiratory Care community

h. Volunteers time and expertise to the profession and the patients we serve

i. Possesses a positive attitude and excellent work ethic

j. Most likely to contribute to the PSRC’s mission and purpose

NOMINATIONS ARE DUE BY FEBRUARY 28, 2025

Full Name*

First NameLast Name

Company*

Position*

E-mail*

example@example.com

Phone Number*

Name of Nominated Person*

E-mail Address (if known)

example@example.com

Phone Number (if known)

Employer (if known)

Education Credentials:

Professional Credentials:

Years in the Profession:

20-24 Years> 25 YearsUnknownOther

Field of Specialty / Discipline:

Curriculum Vitae*

Please submit a curriculum vitae for the Lifetime Achievement Award nominee.

Please provide a description of why this person should be considered for a Lifetime Achievement Award. In your description, please highlight the nominee’s contribution(s) to the PSRC throughout their career. Also include a description of their commitment, dedication, excellence, compassion, professionalism, volunteerism, attitude, and work ethic as well as any significant contributions to the profession and its patients. *

PSRC Lifetime Achievement Award Nomination Form

Nominator:

Nominee Information