Nomination Form

Please fill out all form fields, everything is required for submission. Thank you for your participation in the NLA.

Candidate Information

Qualification 1*

Yes

Is the candidate widely known for a major contribution to clinical lipidology (research, teaching, publishing or service)—either as a single accomplishment or through lengthy service?

Qualification 2*

Yes

Is the candidate a member of the NLA in good standing? (An exception to this rule will only be made in extraordinary circumstances.

Candidate Name *

Candidate City *

Candidate State *

Reason for nomination: (list significant achievements) *

Attach a file

Submit at least one letter from an individual familiar with the candidate's work. This supporting documentation should clearly articulate the candidate's contributions to the field of lipidology and to the NLA.

Files must be less than 3 MB.
Allowed file types: gif jpg jpeg png txt pdf docx.

Your Information

Your Name *

Your Phone *

Your Email *