NOMINATION FOR THE INNOVATORS AWARD

The Innovators Award is presented annually, when appropriate, to a member of The American Society of Group Psychotherapy and Psychodrama whose work significantly and in new directions extends the applications or methods of psychodrama, sociometry, and/or group psychotherapy. Please complete the following form in as much detail as possible.

Name of Nominee______________________________________________________________

Address_______________________________________________________________________

City____________________________ State____________ Zip_______________

Phone ______________________________________ FAX ______________________________

E-mail ______________________________________________

In narrative form on a separate sheet, state how the nominees’ work has significantly and in new directions extends the applications or methods of psychodrama, sociometry, and/or group psychotherapy. Please sign your statement and list your address.

Signature of Nominator (may be self-nomination) ______________________________________

Address_______________________________________________________________________

City____________________________ State____________ Zip_______________

Phone ______________________________________ FAX _______________________

E-mail address__________________________________________

Nominations must be postmarked no later than:

August 1

Please mail this form to the national office:

American Society of Group Psychotherapy and Psychodrama

301 N. Harrison Street Suite 508 Princeton, NJ 08540