(Eligibility criteria: Physicians, Nurses, Allied Health Professionals, Administrators)
Submission deadline: 20 June 2021
All information is treated with confidence. The information is furnished to the committee of the Med ACP Faculty Development Office with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes only.
B. Reasons for nomination
The Education Awardee is expected to fulfil the following pre-requisites. Please provide specific evidence explaining how the nominee satisfies the criteria. Self-nominations are allowed; in this case, the nominator and nominee is the same person.
Criteria 1: Team-based educational initiatives
(Please ensure that examples and evidences provided are as specific as possible)
Criteria 2: Contributions to educational landscape
Criteria 3: Inter-professional collaborations (if any)
C. Other Achievements
Please include a list of Academic or Professional honours the team has received (i.e. awards and prizes, membership in honourary societies and year the honour(s) were attained), if any.
D. Declaration by Nominator
I declare that all the information provided in this application form is true and correct to the best of my knowledge.
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