ADS Jeff Flack Diabetes Data Award Application

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Categories of merit include:

Multiple / Significant / Substantial Publications (or In Press) involving data collection, collation, analysis and reporting (beyond ‘routine day-to-day’ minimum dataset collection);
Something ‘Novel’ regarding data collection / reporting – development of data systems;
Substantial contribution to data issues (attendance / chair of Committee(s) on data issues – developing standards etc);
List the best 5 or 10 relevant publications;
Highlight all relevant publications in your CV.

Nominations should include a letter (not exceeding 2 pages) clearly stating the basis of the nomination and a full curriculum vitae.

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Applicant (Nominee's) Full Name*

Title First name Surname

Institution*

Address*

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

Email*

Are you a current financial member of ADS for at least one year?*

Yes

Have you applied for this award/grant/fellowship previously?*

Yes

Nominator/s Full Name

Files (Nomination letter, CV)*

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Phone

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