Weight Management Practice Group
Excellence in Weight Management Practice Award
Purpose: To recognize individuals who have demonstrated excellence of practice in the area of
weight management. Qualifications include exceptional performance in weight management
practice, contributions to the advancement of weight management practice and leadership in
weight management or dietetics-related organizations.
Eligibility: All active members of the American Dietetic Association and the Weight Management
Dietetic Practice Group (WMDPG) in good standing may nominate her/himself or a candidate.
WM DPG elected officials, Directors, Newsletter and Web Editors and Awards Committee
members including judges are not eligible.
Application Information:
 Nominations may be submitted by any member of WMDPG, including self nominations.
Nominations should be submitted using the Award Application Form.

Additional information that is accepted, although optional, includes current vitae or
resume and supporting information such as curricula outlines, illustrations/pictures of
products, etc. (Note: all materials must be submitted electronically and should not
exceed 12 8½ x 11-inch pages).

Letter (s) of support must accompany the nomination (maximum of 3). Letters of support
will be held for two years in case an applicant applies annually. Please submit letters or
notification of letters with application.

Candidates may be contacted to assist in completing the nomination packet.

Entry deadline: April 15, 2010.

The winner will be notified within six weeks.
The Award: The award will be given at ADA’s Food and Nutrition Conference and Expo (FNCE).
WM DPG will provide the winner with a $1000 cash award. In addition, the following costs will
be reimbursed: symposium registration, transportation and other expenses incurred during
FNCE. The WM Treasurer will communicate with the winner to provide instructions on travel,
housing and registration, and details on completing the WMDPG approved expense form. The
winner will be responsible for any taxes associated with the $1000 cash award. If the winner is
not able to attend the Award Ceremony at FNCE then the winner will receive only the $1000
cash award.
Weight Management Practice Group
Excellence in Weight Management Practice Award
Nomination Form
Name of Candidate __________________________________________________
Address ___________________________________________________________
City________________________________ State__________ ZIP_____________
Phone (w) _______________(h) ________________ (cell)___________________
Email______________________________________________________________
Submitted by (if different from the candidate)
Name: _____________________________________________________________
Address____________________________________________________________
City________________________________ State__________ ZIP______________
Phone (w) _______________(h) ________________ (cell)____________________
Email_______________________________________________________________
Qualifications
1. Member of ADA: (member #) _________ Member of WMDPG _______ years
2. Qualifications Summary Statement (provide a brief summary of the qualifications of the
nominee for this award.
3.
Qualifications Narrative Statement (describe how the nominee is qualified in each of the
three areas below; points are assigned to each area)
A. Exceptional performance in weight management practice as demonstrated by
these six criteria:
1. Client Service – improved access to nutrition care, client focus, collaboration,
individualized care
2. Nutrition Care Process – assessment, nutrition diagnosis, nutrition
intervention, and monitoring and evaluation
3. Evidence Based Practice – Evidence Analysis Library, ADA Practice Guidelines,
other evidence-based interventions
4. Program(s) Scope – program description; size – numbers of participants, budget;
care across the health care continuum; populations served (ethnicity, age,
socioeconomic status, etc.); development of education resources and materials
5. Program(s) Impact – Demonstration of outcomes and use of outcomes data for
program management; professional impact; program stability over time – long
term service to selected patient/client population; coverage and reimbursement
6. Communication – promotions to clients, payers, providers, administrators;
sharing results
Range 0 -10 points for each area; total: 0 - 60 points
B. Contributions to the advancement of weight management practice as
exemplified by the following criteria:
1. Curricula, publications, presentations, teaching tools, and/or innovative
techniques/methods, etc., that advance the field of weight management.
Range 0 - 30 points
C. Leadership achievements in weight management- or dietetics-related
organizations (appointments, elected positions, honors, etc.):
1. ADA (national, state, district and dietetic practice groups)
2. Other weight management or dietetic organizations
Range 0 - 10 points
Submission
The nomination should be submitted as an electronic packet by April 15, 2010. In addition to the
information above, the packet should include a maximum of three letters of support. The packet
may also include an Appendix containing optional items such as a curriculum vitae or resume,
and illustrative materials including photographs, charts, a table of contents, etc.
Note: the complete nomination packet should not exceed 15 pages including the letters
of support and items in the Appendix.
Submit the nomination in a Microsoft Word document (not less than 11 point font) to WMDPG
Awards Chair: Lori Tanner at lori.tanner@multicare.org
Thank you for submitting a nomination.