NOMINATION FORM

The FMWC sponsors this annual award to recognize the FMWC medical student member showing the most potential in the realm of leadership. Particular interest is given to candidates who demonstrate leadership in support of the FMWC mission statement. The award will be given out to the successful nominee at the next FMWC Annual General Meeting & Educational Sessions.

Both the nominee and the nominator are required to be current FMWC members. The deadline for nominations is January 10th.

FMWC Student Leadership Award

Nominee's name:
Nominee's FMWC branch:
Nominee's medical school & graduating year:
Nominee's email address:
Nominee's phone number:
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Nominator's name:
Nominator's FMWC branch:
Nominator's medical school or workplace:
Nominator's email address:
Reasons you are nominating this medical student for the FMWC Student Leadership 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:

2012 – Margaret Olszewski

Awards

Student Leadership Award

NOMINATION FORM

FMWC Student Leadership Award

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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]**.