October 1999 Bulletin
AAOS HUMANITARIAN AWARD CANDIDATE NOMINATION FORM
General Guidelines
- Candidate must be nominated by a sponsor
- Candidate must be a fellow of the AAOS
- Candidate must have demonstrated an exemplary and outstanding
commitment to musculoskeletal-focused humanitarian activities,
either domestically in the USA or abroad
- If selected to receive an award, candidate agrees to attend,
at candidate's expense, the 2000 Annual Meeting in Orlando, Florida
- Candidates will be asked to complete a candidate activity
summary form
- All nomination forms must be received at the AAOS office
by Nov. 1, 1999.
NOMINATION INFORMATION: PLEASE COPY THIS FORM AND PRINT
OR TYPE
1. Sponsor:
Name:
Address:
Tel: Fax: E-mail:
Number of years you have known candidate:
Relationship to candidate:
2. Candidate
Name:
Address:
Tel: Fax: E-mail:
Candidate age: AAOS member since:
Candidate willing to attend 2000 Annual Meeting to receive award: _
Yes _ No
3. Briefly tell us why
you believe your candidate should be considered for the AAOS Humanitarian
Award.
Fax or mail this form to: Barry Gainor, MD, c/o Anna Santillan,
AAOS Humanitarian Award, American Academy of Orthopaedic Surgeons,
6300 N. River Rd., Rosemont, IL 60018; Fax: 847. 823. 8027.