ASRS Presidents' Young Investigator Award nomination form

Your information

Your name *

Your email *

Nominee

Nominee must be an ASRS member age 45 or younger.

Nominee name*

Type the first few letters of the member's name.

Statement of nomination*

Briefly explain how the individual has distinguished himself or herself for this award.

I attest that the nominee is age 45 or younger

Co-author(s)

Co-author(s) will be contacted via email to acknowledge nominee is primary investigator.

201

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Paper

Title of paper *

Name of clinical research trial/study *

Journal/publication *

Paper publication date must be between January 01, 2017 and December 31, 2017

Publish date *

mm/dd/yyyy

Documentation

PDF format only. 10 MB maximum file size.

Nominee's curriculum vitae*

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Paper*

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