Formulaire de mise en candidature au Prix Dr Marshall Mallett (lampe de la connaissance)

Life Membership Award

One form per nominator.

Please be detailed in your responses. This will demonstrate to the Honorary Awards Committee and Board of Directors proper context of how the nominee meets and/or exceeds the requirements of the award.

Personal Information of nominee

Nominee's full name *

Address

City

Province

Postal Code

Telephone

Discipline

Is the nominee a CAMRT member?

Yes

Submitted by

Name *

Member no.

Telephone during the day

Your Email *

Do you give CAMRT permission to disclose your name as nominator to the nominee if requested?

Yes

Judging Criteria

Please answer the following questions which are based on established judging criteria for nomination of an individual for Life Membership. Limit response to each question to 250 words. If possible use examples that are different or expand upon the information provided in the nominee’s CV.

What has the nominee done to promote the profession nationally and/or internationally?

Does the nominee’s leadership serve to motivate others to become involved in professional activities? For example, referring others to volunteer for CAMRT, writing for the Journal of Medical Imaging and Radiation Sciences, etc. Please provide examples.

Has the nominee been involved in raising the profile of the CAMRT by motivating others to become involved or helped members better understand the work CAMRT does and how it impacts them? Please provide examples.

Has the nominee made regular contributions to the CAMRT? For example, on an annual or bi-annual basis. Please provide examples.

Is the nominee recognized as a leader in the profession? Please explain.

Are there other noteworthy accomplishments by this nominee that should be mentioned? Limit response to 400 words.

If available, also include a copy of the nominee's curriculum vitae (Word or PDF format).

Attachment

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