ConnOTA Awards and Criteria
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- Christian Gibbs
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1 Awards and Criteria 1. Award of Service a. Objective: To recognize individuals who have made significant contributions in advancing the mission and strategic goals of and the practice of occupational therapy in the state through community leadership or advocacy. i. At least 3 years as a member in good standing. ii. Five years of experience as OT or OTA. iii. Evidence of significant service to the state association or community organizations in the form of leadership or advocacy for the profession and/or clients. 2. Award of Merit a. Objective: To recognize individuals who have attained outstanding accomplishments in clinical practice, research, leadership or innovation and whose body of work is considered exemplary and influential by peers. i. At least 1 year as a member in good standing. ii. Current licensure as an OT or OTA in the State. iii. Three letters of commendation from peers. iv. Evidence of accomplishments that are deemed exemplary and influential in the practice of OT. 3. Fieldwork Supervisor of the Year a. Objective: To recognize exceptional clinical teaching by occupational therapists and occupational therapy assistants that promotes ethical and evidence-based practice and professional advocacy in students. i. At least 1 year as a member in good standing. ii. Minimum of five years of practice as a licensed OT or OTA. iii. Proof of at least 2 years of supervision of a Fieldwork Level II student from an accredited OT or OTA program within the State. iv. Nomination must accompany 2 recommendations written by:
2 1. A Fieldwork level II student who was supervised by the nominee within 3 academic year of the nomination. 2. A peer review from an occupational therapist or occupational therapy assistant / fieldwork coordinator who can attest to the nominee s excellence in clinical teaching. 4. Emerging Leader Award a. Objective: To recognize an occupational therapy student or an early practitioner (2 years of experience or less) who has demonstrated outstanding leadership at the local or organizational and state or national levels. i. At least 1 year as a member in good standing. ii. Student: He/she must be enrolled currently in an occupational therapy (OT/OTA) program within the state. iii. Practitioner: He/she must have practiced occupational therapy within the State for 12 months. iii. 3 letters of recommendation from mentors who could vouch for his/her leadership potential and accomplishments.
3 Connecticut Occupational Therapy Association AWARD NOMINATION FORM Purpose and Description: The overall purpose of Awards is to recognize occupational therapy practitioners in the State of Connecticut who with their time, knowledge and expertise have made significant contributions to the advancement of occupational therapy practice in the State and to the health and well-being of Connecticut citizens and their communities. The NOMINEE is being nominated for the following award (Choose one): Award of Service FW Supervisor of the Year Award of Merit Emerging Leader Award Information about the PRIMARY NOMINATOR: Name/Credentials: Member? Yes No If No, last date renewed: Address: Job Title/Position: Affiliation: Phone/Fax:
4 INFORMATION ABOUT THE NOMINEE: Name/Credentials: Membership Address: Member since: Date: Expiration Job Title/ Affiliation: Phone/ Preferred Time: QUALIFICATIONS: The nominee s curriculum vitae is attached: Yes No Please provide a synopsis of the Nominee s relevant experiences. Please do not exceed 500 words. Supportive documents are appended: Yes No List the supportive documents below: NARRATIVE: Provide a narrative that describes the individual s contributions and justification for his/her receipt of the award. Please do not repeat the information provided under relevant experience. Please refer to the objectives and criteria for the award in which the nominee is being nominated for. The narrative must not exceed five (5) double-spaced pages using 12-pt serif font. Please send your nomination form and supporting materials to 370 Prospect St. Wethersfield CT Or: at Snet.net
5 Scholarship Award Procedure: Amount of Award Not to exceed $500 to any individual in one year. Eligibility Any individual enrolled in an accredited occupational therapy curriculum in Connecticut or any Connecticut resident enrolled in an accredited occupational therapy curriculum outside of Connecticut may apply after having successfully completed at least one semester in that program. At least one year as a member of. Complete scholarship Application and submit to. Solicit a faculty recommendation; present faculty with faculty recommendation form and a stamped envelope addressed to Please send your nomination form and supporting materials to: 370 Prospect St. Wethersfield CT
6 CONNECTICUT OCCUPATIONAL THERAPY ASSOCIATION Scholarship Award Application Name Date Permanent Address School: School Phone # College Address College Year: State your qualifications for receipt of this scholarship award. Academic Standing: (Include other awards) Previous activities pertinent to your future as an occupational therapist or assistant. Contributions you have made to your classmates: Contributions you have made to the community: Future Plans: Additional Information:
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