NOMINATION FORM
THE RICHARD S. HODES, M.D.

HONOR LECTURE AWARD

2012

Deadline for Submittal is June 30, 2012

The Commission encourages electronic submission of all the materials with exception of the letters of support.

Submit nominations to:
Awards Committee
c/o Ted Buckner, Associate Director
Southeast Compact Commission
1230 SE Maynard Road, Suite 103
Cary, NC 27511

Phone: (919) 380-7780
Fax: (919) 380-7710
Email: (secc (at) secompact (dot) org) secc (at) secompact (dot) org

  Printable Version of the Nomination Form

OR

Nominee's Information
  1. Please make sure you enter all required information. If you do not complete the required information your input will be lost and you will need to start your nomination again.
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Citation
Basis for Nomination
Support Letters
  1. Submit by U.S. Mail or courier no more than three brief supporting letters from colleagues, peers or former students. Please do not attach exhibits, samples, etc. Voluminous materials are not useful to the selection committee.
  2. Fax documents to: (919) 821-1090
  3. Or, mail documents to: Awards Committee c/o Ted Buckner, Associate Director Southeast Compact Commission 21 Glenwood Avenue, Suite 207 Raleigh, NC 27603
Nominator Information
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  5. Before "Submitting" this form please make sure you have entered all the required information or you may lose all your input.
 

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