[Skip to Content]

Nominee will submit this information


Please gather ALL required information and documents PRIOR to filling out the Nominee Form. Read the nominee information/membership criteria carefully so you can provide the selection committee with the information that is responsive to these criteria.

All required fields MUST BE completed before you can SAVE your submission.
 

Personal information

  • Name, Degree(s), Academic Title, Email, Department, Institution, Preferred Mailing Address, Office Phone, Cell Phone

  • Preferred Professional Profile (URL)

  • ORCID #

  • DOB, Gender/Gender Pronouns, Disability, First Generation College Graduate, Race/Ethnicity

  • Social Media accounts

  • Regional Society Memberships

Research

  • Clinical Specialty, Research Areas, Research Type, Research Methods/Study Design

Headshot Photo

  • Portrait image should be at least 640×800 pixels (2.133 inches wide by 2.667 inches high at 300 DPI) and can be JPG, TIF, or PNG.

Short Summary of yourself and your research

Terminal Research Training

  • Provide most recent type of research training (Fellowship, Master's Degree, PhD, Post-doc, Residency, Other) withing the last 10 years.

  • When the nominee continues to work in the same institution after completion of fellowship training, it is strongly recommended that the fellowship preceptor provide a letter describing the candidate's independence. The letter should be on letterhead with preceptor's signature. The letter can be uploaded under the "Additional Letters" field. Alternatively, if the Nominator or Seconder has adequate familiarity with the candidate's work, their letter can address independence.

  • Provide terminal research training completion date, institution, department, and name of Research Preceptor/Mentor/Thesis Advisor (if applicable).

Education

  • Beginning with college, chronologically list schools attended, with dates and degree(s) earned, if any, at each institution.

Professional Activity

  • Beginning with house staff training, chronologically list all professional positions, giving dates of each position.

Research Support

  • In the last 3 years, list by title, source and dates, peer-reviewed support for research activities (grants and contracts) on which you are a Principal Investigator or have a major role. 

  • For each entry briefly describe your role in obtaining funding and carrying out the work (e.g. wrote (particular) sections of the grant, leading pharmacokinetic analyses).

Bibliography

  • Original articles published in the last 3 years, including articles in press. 

    • Please list in chronological order. List authors in the same order as the original manuscript. Asterisk (*) the original research manuscript(s) that best reflect justification for SPR membership.

    • For Articles in Press that are not yet available online, a letter from the publisher must be included.

    • For each entry that best reflects justification for SPR membership: Describe your role in the research and the hypothesis(es) that the manuscript addresses.

  • My NCBI (url link).

  • Reprints - Submit at least one (but no more than five) publications considered to be the nominee's most representative scientific publication(s). Include only your best, recent, hypothesis-related work. Do not include review articles, position papers, commentaries or chapters. Preprints of articles are permitted if they have been accepted for publication and include a letter of acceptance for publication from the journal. For preprints, a letter from the publisher must be included.

CV

Additional Letters of Support

When appropriate the following should be included:

  • A separate letter of support from a member of the collaborative research group that outlines the nominee's independent contributions.

  • A separate letter from the nominee’s research mentor or fellowship director that describes the nominee’s independent contribution to the original research.

  • Individuals within or outside an individual’s institution can provide letters of support. Of note, peers of the individual who are SPR members in good standing can also provide letters of support.

Other Information. 

  • Clarify any significant interruptions in career or other issues pertinent to review of membership nomination.

Department Chair

  • Nominee to provide Primary Department Chair's name and contact information.

Follow Us Facebook Twitter