CAFP Foundation: Award Nomination Form 2023

Each year, the CAFP Foundation recognizes champions within the family medicine specialty. Join us in this celebration by nominating an individual who has had an impact in your academic, professional and/or personal journey. Please submit this form and materials no later than Monday, May 1, 2023.

Candidate's Contact Information

First Name

Last Name

Address (City, State, Zip)

Phone

Nomination Information

Please indicate an award category for your nomination:

Educational Excellence in Honor of Barbara Harris (Educator of the Year)Family Medicine Resident of the YearExcellence in Family Medicine ResearchPreceptor of the Year Philanthropist of the Year Award

In a few sentences, briefly describe why you are nominating the individual and what in particular, makes the nominee deserving of the award:

Please upload 1 Letter of Support as a Word document or PDF (consider letters from students, colleagues, members of the community and/or others directly involved in the nominee’s endeavors):

Please upload Candidate's CV as a Word document or PDF

Name of Person Submitting Nomination:

Email of Person Submitting Nomination

Contact Information