NOMINATION FORM

The Reproductive Health Award is presented annually to the FMWC full member seen to contribute the most to the field of reproductive health.

When submitting your nomination, please complete the following information and insert the name of one (1) other physician member of the FMWC who accepted to endorse your nomination (reference will be validated). The deadline for nominations is December 31.

Nominee's name:
Nominee's FMWC branch:
Nominee's email address:
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Nominator's name:
Nominator's FMWC branch:
Nominator's email address:
FMWC member endorsement:
Reasons you are nominating this member for the FMWC Reproductive Health Award :

*Please note that this nomination or self nomination isn't complete until the National Office receives a copy of the nominee's CV via email at: [email protected]**.

Past Recipients

2013 – Dr. Jan Christilaw
2011 – Dr. Mary Conley
2010 – Dr. Shayna Watson
2001 – Dr. Shaila Misri
2000 – Dr. Elaine Jolly
1999 – Dr. Vera Frinton
1998 – Dr. Ellen Wiebe
1997 – Dr. Dorothy Shaw

Awards

Reproductive Health Award

NOMINATION FORM

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***Please note that this nomination or self nomination isn't complete until the National Office receives a copy of the nominee's CV via email at: [email protected].

Awards

*Please note that this nomination or self nomination isn't complete until the National Office receives a copy of the nominee's CV via email at: [email protected]**.