Award Nomination Form Submissions for the 2024 awards nominations are now OPEN! Call for Award Nominations "*" indicates required fields Select an award for nomination* New Investigator Educator Award W. Anderson Spickard, Jr. Excellence in Mentorship Award John P. McGovern Award for Excellence in Medical Education Betty Ford Award David C. Lewis, MD AMERSA Service Award About the Nominee*Given to an individual from any discipline who has provided outstanding mentoring to those individuals, resulting in increased scholastic achievement and career advancement in the area of substance use education or research. Nominations are welcome from AMERSA members and consist of a nomination letter (to be completed electronically in the space below) including a description of how the nominee has assisted him/her in his/her teaching and/or research achievements in substance use and helped to advance his/her academic career. The letter should be specific and reference any abstracts, workshops, publications or other presentations in his/her CV. The nominator should include a description of how the nominee has provided career guidance assistance to him/her. The award includes conference registration and a commemorative plaque. Nomination Letter (500 Word Max.)About the NomineeThis award will be given to an AMERSA member who is at an early stage in his/her career, has made significant contributions to substance use education and/or research, and has demonstrated the potential for future achievements in the field. The recipient must have completed a doctoral level degree, and is eligible for nomination within seven years of completing that training or a post-degree advanced training program (e.g. clinical or research fellowship) in any health discipline. An exception to the timing of training will be made in order to consider an investigator/educator who is at a later career stage, yet new to the substance use field and meets the other award criteria. The award includes conference registration and a commemorative plaque. Nominations are welcome from all AMERSA members and should include the individual’s previous substance use education and research activity and his or her potential for future contributions and achievements in the field, and the nominee’s CV. Nomination Letter (500 Word Max.)About the NomineeThe Betty Ford Award is given to an individual who has had a significant impact on the field of alcohol and substance use, particularly with regards to women’s issues, substance use education and recovery. Nominations are welcome from AMERSA members and should consist of a nomination letter (to be completed electronically in the space below) as to why this individual should be considered for the award, and the nominee’s CV. The Betty Ford Award winner is required to deliver a plenary talk at the annual conference. The award includes conference registration and a commemorative plaque. First Lady Mrs. Betty Ford attended and presented at the 1985 AMERSA conference. As described by David Lewis and Sid Schnoll in their 2018 commentary on AMERSA’s 40th anniversary, Mrs. Ford reflected candidly on how her personal physician addressed her alcohol use. She was quoted as saying, “I now believe, he chose to be uninformed about chemical dependency; who did not want to know about the addictive properties of the prescriptions that he had handed out; and chose to ignore the impact my alcohol use was having in combination with the pills I was taking.”1 Learning that AMERSA was in financial straits and impressed with the “ME” in AMERSA – medical education, now multidisciplinary education – Mrs. Ford contributed $10,000 from the royalties of her new autobiography to support AMERSA. That milestone in the organization’s history is commemorated by the Betty Ford Award and plenary at the annual conference. 1Lewis, D., & Schnoll, S. H. (2018). Commentary on the 40th anniversary of AMERSA: AMERSA at 40: How it all began and how it survived. Substance Abuse, 39(2), 134-138. Nomination Letter (500 Word Max.)About the NomineeGiven to an individual who has made important contributions to substance use education and research. Nominations are welcome from AMERSA members and should consist of a nomination letter (to be completed electronically in the space below) as to why this individual should be considered for the award, and the nominee’s CV. *The John P. McGovern Award winner will be required to deliver a plenary talk. The award includes a $500 honoraria, conference registration and a commemorative plaque. Nomination Letter (500 Word Max.)About the NomineeThe David C. Lewis, MD AMERSA Service Award was established in 2017 to honor Dr. Lewis’ tremendous contributions to the Association for Medical Education and Research in Substance Abuse. The Award symbolizes the highest level of service to the association. This award will be given to an AMERSA member for outstanding service to AMERSA and its mission to improve health and well-being through interdisciplinary leadership in substance use education, research, clinical care and policy. Nominations are welcome from AMERSA members and should consist of a nomination letter (to be completed electronically in the space below) as to why this individual should be considered for the award, and the nominee’s CV. The award includes conference registration and a commemorative plaque. Nomination Letter (500 Word Max.)Your Name* First Last OrganizationYour Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Is this address for:* Home Institution Phone*FaxEmail* Your CV*Accepted file types: jpg, gif, pdf, png, doc, xls, Max. file size: 256 MB.Nominee's CV*Accepted file types: jpg, gif, pdf, png, doc, xls, Max. file size: 256 MB. 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