Rural Recognition Award Nomination

Distributed Learning & Rural Initiatives (DLRI) recognizes the work and passion that our rural preceptors, residents, teachers, and health care professionals bring to their communities. Thank you for acknowledging their outstanding contribution.

For more information and award criteria visit https://cumming.ucalgary.ca/ruralmedicine/physicians/awards or email dlri@ucalgary.ca

Please submit one nomination per category. A nominee may be nominated in multiple categories.

Prefix

First name of nominator

Last name of nominator

Email of nominator

Phone of nominator

Prefix

First name of nominee

Last name of nominee

Email of nominee

Nominee practice location (if applicable)

Award category (One nomination form per category required)

Nomination Letter

Choose file

Outline the merits of the nominee and state how they meet the award criteria. Include achievements, positive contributions, and impact the nominee has made both professionally, personally, and in the community. Please include your personal experience, observations, and anecdotes of the nominee. Click here for a nomination letter example.
One file only.
10 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

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