Please fill out all required fields on the next page and upload attachments to the system. Deadline: September 15, 2016

Eligibility Criteria

1. The nominee has been a member of the Child Neurology Society for at least 20 years.

2. The nominee is recognized for an outstanding commitment to child neurology, patient care and humanism in medicine, as assessed by the nominator(s), colleagues, trainees, and patients and their families.

3. The nominee is recognized for leadership or service to the Child Neurology Society.

4. The nominee is recognized for a life-long career devoted to child neurology as a clinical discipline, whether as a practitioner, clinical investigator, or advocate for the principles of the Child Neurology Society.

Procedure

1. Submit an electronic nomination on-line by clicking link to be posted on CNS website August 10

• Be prepared to enter nominee’s complete contact information

2. Merge the following documents into a single PDF file (no .doc or .docx formats):

• Letter of Nomination, 2-5 pages in length, double-spaced. The letter should include a statement of the applicant’s eligibility for this award, as outlined above.
• A recent copy of the nominees’ curriculum vitae.
• Up to 3 additional letters of support (optional). A single nominator should coordinate combining CV and up to three letters of support into a single PDF file.

3. On-line nominations must be uploaded to the CNS website on or before September 15, 2016.

4. The 2017 awardees will be informed of the committee’s decision by December 31, 2016. 

5. There will be a five-minute introduction to the Child Neurology Society membership at the 46th Annual Meeting of the Child Neurology Society on Thursday, October 5, 2017 in Kansas City, MO. The introduction will be followed by a brief comments, but no formal presentation by the recipient.

Questions? Contact: 

Roger Larson, CAE
Executive Director
rblarson@childneurologysociety.org