2015 APA Awards Nomination Form

Transcription

2015 APA Awards Nomination Form
2015 APA AWARDS SOLICITATION
Award Nominations
Each year APA encourages members to submit the names of individuals who are deserving of special
recognition for their professional activities during the past year. Any active APA member is eligible to
nominate a person for the awards. Award recipients are chosen by an APA committee following a review
of all nominees. Nominations are now being accepted for the following annual awards to be presented
by the Association. Nominations will close at 4:30 p.m., April 3, 2015.
Please mark your nomination with an X. If you have more than one nomination, please feel free to copy
this form.
Pharmacist of the Year _______
The Pharmacist of the Year Award was established in 1959 to honor an individual who “should possess
professional standards beyond reproach, a record of outstanding civic service in the community, and as
a member of the APA, who has contributed efforts toward the progress of the association.” Previous
recipients include:
2014 Michelle Crouse, Lake Village
2013 Carl Collier, Fayetteville
2012 Charles Born, Little Rock
Bowl of Hygeia Community Service Award _______
In 1958 E. Claiborne Robbins of the A.H. Robbins Company established the Bowl of Hygeia Award. It is
sponsored by the American Pharmacists Association Foundation and the National Alliance of State
Pharmacy Associations, with premier support from Boehringer-Ingelheim. The purpose of the award is
to encourage pharmacists to take active roles in the affairs of their respective communities. Previous
recipients include:
2014 Eric Shoffner, Newport
2013 Vicki and Karrol Fowlkes, Little Rock
2012 Sparky Hedden, Sheridan
Cardinal Health Generation Rx Award _______
This award, sponsored by the Cardinal Health Foundaton, honors a pharmacist who has demonstrated
outstanding commitment to raising awareness of the dangers of prescription drug abuse among the
general public and among the pharmacy community. The award is also intended to encourage
educational prevention efforts aimed at patients, youth, and other members of the community.
Previous recipients include:
2014 Denise Robertson, Little Rock
2013 Lelan Stice, White Hall
2012 Dennis Moore, Batesville
Distinguished Young Pharmacist of the Year _______
The nominee must have an entry degree in Pharmacy, received nine or fewer years ago, and be a
member of the APA. Nominee must be in the active practice of pharmacy in the year selected, and
actively involved in the profession of pharmacy, displaying an interest in the future of the profession.
Previous recipients include:
2014 Stephen Carroll, Arkadelphia
2013 Zach Holderfield, Fayetteville
2012 Clint Recktenwald, Gassville
Excellence in Innovation Pharmacy Practice Award _______
This award was established in 1993 by the APA in cooperation with the National Alliance of State
Pharmacy Associations to recognize, annually, a pharmacist who has demonstrated a prominent spirit of
innovation and entrepreneurship in the practice of pharmacy. It is sponsored by Upsher-Smith
Laboratories. Previous recipients include:
2014 Marcus Costner, Fayetteville
2013 Lanita White, Little Rock
2012 Melissa Brown, Fayetteville
Guy Newcomb Award _______
The APA Board of Directors created this award in 1997 to recognize individuals who, by their legislative
influence and leadership, have distinguished themselves as political friends of Arkansas pharmacy. This
award is named in memory of Dr. Guy Newcomb of Osceola. Dr. Newcomb was a pharmacy leader who
understood, appreciated, and enthusiastically participated in the political process. Previous recipients
include:
2011 Johnny Key, State Senator, Mountain Home
2009 Allen Maxwell, State Representative, Monticello
1999 Larry Teague, State Representative, Nashville
Percy Malone Public Service Award _______
This award was established in 2009 by the Arkansas Pharmacists Association in honor of former state
senator Percy Malone, P.D. The recipient must have made a contribution to public service by being
elected to any public office and by displaying an interest in the people of Arkansas. Previous recipients
include:
2011 Gene Boeckmann, Wynne
2009 Percy Malone, Arkadelphia
Name of Nominee___________________________________________________________
Address___________________________________________________________________
City/State/Zip ______________________________________________________________
Phone _____________________________________________________________________
Reasons for selecting nominee: Attach one page with a description of reasons for the nomination and
the individual nominee’s resume and contact information should they be selected.
Nominator’s Name:
___________________Phone____________________________Date_______________
Fax or email written nomination form and material to: Awards Committee, Arkansas Pharmacists
Association; [email protected]; Fax 501-372-0546. Please submit by 4:30 p.m., April 3, 2015.