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Nomination


Nominee Information (name of HCP)*
Nominator Information (name of the medical delegate)*
One file only.
5 MB limit.
Allowed types: gif, jpg, png.
One file only.
2 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Maximum 500 words
File Upload*

You need to provide supporting documents to complete the nomination. (e.g. published article, project information/summary, appreciation letter, etc.)

Unlimited number of files can be uploaded to this field.
13 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.