The FAFP Excellence in Advocacy Award will honor and officially recognize an individual, or individuals, for outstanding work in political advocacy at the local, state, or national level which advances the FAFP’s mission to Support Florida’s Family Physicians.

Characteristics of Eligible Candidates:
  • Successful progress toward or completion of a nominee’s achievement with clear articulation of advocacy plan and actions
  • Innovation of a program or activity
  • Generalization of the project or process
  • Sustained impact on local, state or national arena
  • Documentation that the specific work or activity inspired others to achieve the advocate's mission or to develop their own
Requirements - All nominations must include the following information to be eligible for consideration:
  • A completed nomination form via this application
  • Current Curriculum Vitae
  • A minimum of one and a maximum of three letters of recommendation
  • Color professional photo of candidate
Submission Deadline:  The FAFP Excellence in Advocacy Award nominations can be submitted at any time throughout the year.   The FAFP Board of Directors will determine the most appropriate time and venue for presenting the award.  Questions should be submitted to Deborah Walker at dwalker@fafp.org or (904) 726-0944.

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* 1. Name of individual completing application (include email address):

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* 2. Physician Nominee Name:

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* 3. Physician AAFP/FAFP Member ID:

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* 4. Is the Nominee aware of the award submission?

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* 5. If the above nominee is accepted for the award, would they wish to have their name submitted to the AAFP for like award in the coming year?

*Please note that they would be required to submit additional supporting documentation to meet the AAFP's eligibility requirements.

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* 6. Physician Home Address (include address, city, state and zip code):

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* 7. Physician Home Phone Number:

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* 8. Physician Office Address (include address, city, state and zip code):

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* 9. Physician Office Phone Number:

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* 10. Physician Email address:

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* 11. Please upload a copy of the physician's CV for review (limited to 5 pages):

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* 12. A minimum of one and a maximum of three letters of recommendation

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* 13. Color professional photo of candidate.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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