Academy For Eating Disorders :: Media Center : Find an Expert

Nomination Form

Fields marked with an asterisk(*) are required.

Your Name
Your E-mail Address
Name of Nominee
Nominee's E-mail
Position Nominated For*
Years of Membership in AED
Have you contacted the nominee?	Yes No
Is the nominee willing to be nominated?	Yes No
Nominee Infomation
Years of Membership in AED
Qualities or skill set that makes her/him an excellent nominee:
Committee/Council Membership (names/years)
1.
2.
3.
4.
Committee/Council Leadership (names/years)
1.
2.
3.
4.
ICED Program Committee Member?	Yes No Date
ICED Program Committee Co-Chair?	Yes No Date
Significant Contributions to AED?
Prior Leadership or Board Positions in other organizations?

Updated: June 6, 2007