Award Nomination Form

CMBES Award Nomination Form (Seconder)

Nomination Category

To second a colleague, select the particular Award or Status from one of the following categories.

Nomination for: *

Award - Outstanding Canadian Biomedical Engineer

Award - Outstanding Canadian BMET

Award - Early Career Achievement

Membership Status - Fellow

Membership Status - Emeritus

Membership Status - Honorary Member

Nominator Information (Seconder)

Nominator's First Name *

Nominator's Last Name *

Nominator's Title

Nominator's Email *

Nominator's Phone *

Nominator's Date Joined to CMBES

Mailing Address

Nominator's Address1 *

Nominator's Address2

Nominator's City *

Nominator's Postal Code/Zip *

Nominator's State/Province *

Nominator's Country *

Nominee Information

Nominee's First Name *

Nominee's Last Name *

...

How do you know the nominee? *

How long have you known the nominee? *

Please provide a citation (maximum 500 words) detailing why you believe the nominee should receive this award. You may want to refer to the description of the award to ensure your citation addresses the award criteria.

Please provide a citation (maximum 500 words) detailing why you believe the nominee should receive this award. You may want to refer to the description of the award to ensure your citation addresses the award criteria. *