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2013 Theodore Reich Young Investigator Award NOMINATION ...

2013 Theodore Reich Young Investigator Award NOMINATION ...

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International Society of Psychiatric Genetics (ISPG)<strong>2013</strong> <strong>Theodore</strong> <strong>Reich</strong> <strong>Young</strong> <strong>Investigator</strong> <strong>Award</strong><strong>NOMINATION</strong> FORMThe <strong>Theodore</strong> <strong>Reich</strong> <strong>Young</strong> <strong>Investigator</strong> <strong>Award</strong> is given for published work onpsychiatric genetics that is of exceptional merit. Candidates must be 40 years oryounger in <strong>2013</strong> for consideration and need not be a member of the ISPG.The deadline for nominations is Friday, June 7, <strong>2013</strong>.Email this form, along with full CV to: info@ispg.net with subject line:“ISPG <strong>2013</strong> <strong>Theodore</strong> <strong>Reich</strong> <strong>Award</strong> Nomination Application”NOMINATOR INFORMATION (must be current member of ISPG):NameAffiliationAddressCity State ZipEmailTelephoneFaxNOMINEE INFORMATION:NameAffiliationAddressCity State ZipEmail


TelephoneFaxNomineePlease write a brief description of the scientific work and achievements justifyingwhy the proposed scientist is eligible for the <strong>Theodore</strong> <strong>Reich</strong> <strong>Young</strong> <strong>Investigator</strong><strong>Award</strong>. Please attach a current CV that includes up to four published or in-pressmanuscripts.Citation (max 400 words)Nominator - please print name:Signature:_________________________________________________________Date: __________________________________

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