Faculty and/or Resident Award Nomination Form


Nominee's Name:	:
Nominated by: (your name)	:
Housestaff/Resident Award This award is given to a resident who has been identified by the students as providing excellent mentorship and clinical teaching during the undergraduate years.	:
Adjunct Award This award is given to an adjunct faculty member who has been identified by the students as providing excellent mentorship, clinical and/or classroom teaching during the undergraduate years.	:
Fulltime Award This award is given to a fulltime faculty member who has been identified by the students as providing excellent mentorship, clinical and/or classroom teaching during the undergraduate years.	:

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