2019 Psychiatric Services Achievement Awards application

Submission deadline: August 31, 2019

Only APA members can submit applications

Please note that a complete submission must include:

this completed online form
Program Description

Please email questions to: achievementawards@psych.org

Program eligibility criteria:

In full operation for a minimum of two (2) years before the application deadline
Has overcome obstacles
Offers services to the mentally ill or disabled
Can serve as a model for other programs

This is an online form and all information you enter in the application will be sent to us electronically. Please complete all fields. You can save this form and retrieve for editing if it has not been submitted. Be sure to read over your application, make any corrections and print a copy for your records before it is submitted.
For help with this form, call 202-559-3900.

1. Applying Program Name (150 characters limit) *This question is required.

2. Upload program logo *This question is required.

File: {{filename}} delete

3. Program became fully operational *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

4. Address of Program (400 characters limit) *This question is required.

5. City *This question is required.

6. State

7. Zip code

8. Country *This question is required.

9. Program Director Name (200 characters limit) *This question is required.

10. Program Director Email *This question is required. This question requires a valid email address.

11. Title (200 characters limit)