2021 Professional Conduct Disclosure Form - Awards

The below documentation is required in order to be considered for an Entomological Society of America award.  As a candidate for an ESA award please complete this online Professional Conduct Disclosure Form no later than the below date based on the award type you are nominated for. 

If you have questions regarding the Professional Conduct Disclosure, you may contact ESA’s Executive Director, Chris Stelzig.

The undersigned hereby affirms that he/she has read, understands, and agrees to comply with the ESA Code of Conduct and Ethics, and other policies and procedures established by ESA, as amended from time to time. By signing this document, I certify that, to the best of my knowledge, the below response and all information provided by me related to this Professional Conduct Disclosure Form are truthful, accurate, and complete, and I agree to notify ESA promptly of any material changes required in my responses to the below question. I acknowledge that failure to comply with ESA’s policies may result in my ineligibility to receive, or revocation of, any ESA award, honor, other type of ESA recognition, or governance position, and is grounds for potential sanctions against me.