APA Awards Application

2026 APA Awards Program Common Nominations Form

Please select if you are applying or nominating someone else for an APA award:(Required)

Please select the APA award:(Required)

Nominator Contact Information

Only fill out this section if you are submitting a nomination for someone else.

Full Name of Nominator (if different from Nominee)(Required)

First Last

Degree(s)

Title

Institution

Nominator Email(Required)

Nominee Contact Information

Name(Required)

First Last

Degrees(Required)

Title(Required)

Institution(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email(Required)

Does the nominee identify as underrepresented in medicine (UIM)?(Required)

Yes

*The APA defines UIM using the AAMC's 2004 definition: "Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population," which includes the following racial and ethnic groups: Black or African American, Hispanic/Latino, Native American or Alaskan Native, Native Hawaiian and other Pacific Islander.

Ethnicity

African American

Asian

Caucasian, Non-Hispanic

Hispanic

Other

Prefer not to answer

Unknown

Please upload application materials.

Application materials vary by award. All awards require a CV, two letters of recommendation, a nomination statement, and a lived experience statement.

Please upload the nominee's CV.(Required)

Max. file size: 128 MB.

Please upload letter of recommendation #1.(Required)

Max. file size: 128 MB.

The letters of recommendation should be no more than 1-2 pages each, highlighting the nominee’s accomplishments and explaining why the nominee is deserving of the award. The letters can be written by the nominator, a supervisor and/or a colleague.

Please upload letter of recommendation #2.(Required)

Max. file size: 128 MB.

Please upload the nomination statement.(Required)

Max. file size: 128 MB.

*500 word maximum. Nomination statements should speak to the nominee’s contributions to the field of pediatric academic medicine and other successes related to the award category for which they are being nominated.

Please upload the lived experiences statement.(Required)

Max. file size: 128 MB.

*500 word maximum. This statement should describe how societal factors have shaped your career interests and growth as an academic child health professional. This may include socioeconomic factors, growing up in rural areas, and other challenges, hardships, and unique life experiences that have contributed to your personal and professional narrative.

Please upload the program description.(Required)

Max. file size: 128 MB.

Program awards require a program description. Templates are provided on the individual award pages.

Please upload the nominee's mini education portfolio.(Required)

Max. file size: 128 MB.

A template is provided on the individual award pages.

2026 APA Awards Program Common Nominations Form

Nominator Contact Information

Nominee Contact Information

Please upload application materials.

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