OA 2025-Trainee Member-Application form

KBHN Annual Outstanding Awards 2024-2025 Outstanding Trainee Member Award

Nomination Form
Nominee Information
Name*

First NameLast Name
Email*
Phone Number*
Academic Level (Undergraduate, Graduate, Postdoctoral):*
Institution/Organization:*
Nominator Information
Name*

First NameLast Name
Position/Role*
Organization/Institution*
Email*
Phone Number*
Nomination Details
1. Describe the nominee’s contributions to the field of neurodevelopmental disabilities (max 250 words). Provide specific examples of the nominee’s involvement and engagement in activities, such as participation in events, initiatives, and collaborative projects.*
2. What impact has the nominee had on the field of neurodevelopmental disabilities? (max 250 words). Include measurable outcomes, recognitions, or testimonials that showcase the nominee’s commitment and impact.*
3. Why do you believe this nominee should receive the Outstanding Trainee Member Award for 2024-2025? (max 250 words). Share additional details highlighting the nominee’s dedication, enthusiasm, and contributions.*
Supporting Documents
Attach the CV of the nominee (any format is accepted as long as it is up to date).

Add a maximum of three supporting documents that demonstrate the nominee’s engagement and commitment to the field of neurodevelopmental disabilities, such as letters of recommendation and testimonials from colleagues or mentors.
Nominee CV*

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Attached Document 1*

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Attached Document 2

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Attached Document 3

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Others
How did you hear about this call?*

KBHN NewsletterSocial Media (e.g.,Twitter, Facebook, LinkedIn, Instagram)Other
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Agreement and Signature

By submitting this nomination, you agree that all information provided is accurate and that the nominee has agreed to be considered for this award.
Nominator’s Signature*

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Date*

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KBHN Annual Outstanding Awards 2024-2025 Outstanding Trainee Member Award

Nominee Information

Nominator Information

Nomination Details

Supporting Documents

Others

Agreement and Signature