EXCELLENCE IN LEGISLATIVE ADVOCACY AWARD

Please type or print.

Nominee Name:

Credentials (e.g. RDN, CDN, etc… ):

Academy Number:

District:

Place of Work:

Work Phone Number: ( ) -

Home Phone: ( ) -

Home Address:

APPLICATION AND SELECTION:

  1. Must be a member of the New York State Academy of Nutrition and Dietetics who has never received this award.
  2. Only nominations received via email by the deadline date (February 1, 2016) will be considered.
  3. Selection will be based on the application submission and the established criteria for the award. The candidate’s vitae should be included.
  4. A maximum of three letters of support and a NARRATIVE on the role the member played in the legislative area must accompany the application.
  5. This award will only be given in years where there is an outstanding candidate with distinctive legislative activity.

The Excellence in Legislative Advocacy Award will be determined by the following criteria:

  • Candidate has been consistently and actively involved in the promotion of the profession of dietetics in any legislative initiative.
  • Candidate has been involved in the initiation of legislation regulation and/or governmental policies that would positively affect the profession of dietetics or nutrition.
  • Candidate must be directly involved with leadership and/or advocacy of an initiative.
  • Candidate has encouraged other members to become actively involved in the legislative arena.
  • Candidate must show involvement in the legislative arena for at least three years.
  • Letters of support specifically indicate candidate’s excellence in meeting criteria.

Due by February 1.Email completed application to: with the name of the award in the subject.

LEADERSHIP EXPERIENCE

Please indicate the positions you have held related to legislation.

ASSOCIATION / POSITION / DATE
Academy of Nutrition and Dietetics / 1.
2.
3.
4.
New York State Academy of Nutrition and Dietetics / 1.
2.
3.
4.
District Association / 1.
2.
3.
4.
Other Professional Associations / 1.
2.
3.
4.
Other Comments:

Due by February 1.Email completed application to: with the name of the award in the subject.