Honorary Member Nomination Form

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Honorary Member of the American Association of Anatomists
Nomination Form

Deadline: December 1

Monday, March 22, 2010

Periodically, the Society grants honorary membership to recognize exceptional accomplishments in the field of anatomical sciences. Honorary Members receive a lifetime complimentary AAA membership and may be asked to participate in a future AAA Annual Meeting or contribute a review article to an AAA journal. To nominate an individual for the status of Honorary Member of the American Association of Anatomists, complete this form and submit it with the supporting materials described below. Please note that only current AAA members may nominate an individual for Honorary Membership, but the nominee should not be a member. Only completed nominations received by the deadline will be considered. All successfully submitted nominations may be considered for three years.

Fields marked with a * are required.

Award	Honorary Member of the American Association of Anatomists

Please complete the following information about yourself (nominator) Thank you for your interest in AAA’s awards program. Only AAA members may submit an application for the award application that you have selected. If you are a member, log in to the members only section and all of your contact information that AAA has on file will be populated on the form. If after logging in you are not immediately redirected back to this page, use your browser's back button and refresh. If you are not a current member, you may join AAA online or call the main office at 301-634-7910.
Are you currently a member of AAA?*	Yes No
First Name *
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Last Name *
Title *
Company/University *
Address 1 *
Address 2
City *
State/Country *	/
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Fax
Email *

Please complete the following information about the nominee
Nominee's First Name *
Nominee's Middle Initial
Nominee's Last Name *
Title *
Company/University
Street Address 1 *
Street Address 2
City *
State/Country *	/
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Phone *
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Email *
Suggested citation: (approx. 50 words, suitable for printing, to describe the key accomplishments for which this nominee should be recognized): *

The following materials must be submitted: Be sure that all necessary information is included.

Detailed letter of recommendation:*
Nominee's curriculum vitae (NIH biosketch format):*


Submit this form with supporting materials by December 1.
Only completed nominations received by the deadline will be considered.

American Association of Anatomists
9650 Rockville Pike Bethesda, Maryland 20814-3998
Tel: 301-634-7910 Fax: 301-634-7965 exec@anatomy.org
©2005 American Association of Anatomists