2024 CHADD Lifetime Achievement Award Nomination Form

The CHADD Lifetime Achievement Award celebrates a CHADD member enduring commitment and extraordinary contributions to the ADHD community. This award recognizes an individual who has consistently demonstrated outstanding involvement in advancing understanding, assessment, and treatment of Attention Deficit Hyperactivity Disorder (ADHD), alongside a deep commitment to ethics, professionalism, and positive outcomes.

Please complete this form in its entirety for consideration. Thanks!

Deadline:
Complete the online nomination form by May 30, 2024.

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* 1. Nominee Information

Name

Is the Nominee a current CHADD member?

Years of Membership with CHADD:

Title:

Email Address:

Phone Number:

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* 2. Nominator Information

Your Name:

Your Title:

Your Relationship to the Nominee:

Your Email Address:

Your Phone Number:

Eligibility Criteria:

To ensure the nominee meets the high standards of the Lifetime Achievement Award,

please provide detailed responses to the following criteria:

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* 3. Long-standing Membership and Expertise in ADHD: Describe the nominee’s history with CHADD and their contributions to the ADHD community that demonstrate a deep knowledge and understanding of ADHD.

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* 4. Advancements in ADHD Assessment and Treatment: Provide examples of how the nominee has worked to raise the standards in ADHD assessment and treatment.

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* 5. Excellence in Judgement, Integrity, and Interpersonal Relationships: Detail instances where the nominee has exhibited exceptional judgement, integrity, and maintained outstanding working relationships with individuals, families, and professionals impacted by ADHD.

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* 6. Ethical Standards and Professionalism: Explain how the nominee exemplifies the highest levels of ethics and professionalism within the ADHD community.

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* 7. Contribution to Quality Outcomes in ADHD Through CHADD: Discuss the nominee’s efforts to support CHADD in providing quality outcomes in the area of ADHD.

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* 8. Supporting Evidence: Attach or describe any documents, publications, testimonials, or other forms of evidence that support the nominee’s achievements and contributions to the ADHD community.

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Submission

Please ensure all sections are completed to the best of your ability before submitting this form. If you have any additional questions, comments or concerns regarding the nomination, please reach out to customer_service@chadd.org.

Your nomination helps CHADD recognize and honor those who have made significant, lifetime contributions to the ADHD community.

Thank you for your participation.