{"id":7351,"date":"2015-08-12T16:04:11","date_gmt":"2015-08-12T20:04:11","guid":{"rendered":"https:\/\/camrt.wpenginepowered.com\/fr\/?page_id=7351"},"modified":"2015-08-12T16:04:11","modified_gmt":"2015-08-12T20:04:11","slug":"formulaire-de-mise-en-candidature-au-prix-dr-marshall-mallett-lampe-de-la-connaissance","status":"publish","type":"page","link":"https:\/\/camrt.ca\/fr\/profession-de-trm\/reconnaissance-professionnelle\/prix-honorifiques\/formulaire-de-mise-en-candidature-au-prix-dr-marshall-mallett-lampe-de-la-connaissance\/","title":{"rendered":"Formulaire de mise en candidature au Prix Dr Marshall Mallett (lampe de la connaissance)"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-21\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">Si vous \u00eates humain, laissez ce champ vide.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-21\" value=\"1787253629\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"21\" id=\"\"><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField654\"><div class=\"vfb-form-group\"><label for=\"vfb-field-654\" class=\"vfb-control-label\">Life Membership Award<\/label><div class=\"\"><p><em>One form per nominator.<\/em><\/p>\n<p>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.<\/p>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><h2 class=\"\">Personal Information of nominee<\/h2><span class=\"vfb-help-block\"><h2><\/h2>\r\n<h2><\/h2><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField655\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField656\"><div class=\"vfb-form-group\"><label for=\"vfb-field-656\" class=\"vfb-control-label\">Nominee's full name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-656\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-656\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField657\"><div class=\"vfb-form-group\"><label for=\"vfb-field-657\" class=\"vfb-control-label\">Address<\/label><div><input id=\"vfb-field-657\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-657\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField658\"><div class=\"vfb-form-group\"><label for=\"vfb-field-658\" class=\"vfb-control-label\">City<\/label><div><input id=\"vfb-field-658\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-658\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField659\"><div class=\"vfb-form-group\"><label for=\"vfb-field-659\" class=\"vfb-control-label\">Province<\/label><div><input id=\"vfb-field-659\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-659\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField660\"><div class=\"vfb-form-group\"><label for=\"vfb-field-660\" class=\"vfb-control-label\">Postal Code<\/label><div><input id=\"vfb-field-660\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-660\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-phone\" id=\"vfbField661\"><div class=\"vfb-form-group\"><label for=\"vfb-field-661\" class=\"vfb-control-label\">Telephone<\/label><div><input id=\"vfb-field-661\" class=\"vfb-form-control vfb-intl-phone\" placeholder=\"\" data-default-country=\"ca\" data-hide-flags=\"1\" type=\"tel\" name=\"vfb-field-661\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField662\"><div class=\"vfb-form-group\"><label for=\"vfb-field-662\" class=\"vfb-control-label\">Email<\/label><div><input id=\"vfb-field-662\" class=\"vfb-form-control\" placeholder=\"\" type=\"email\" name=\"vfb-field-662\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField663\"><div class=\"vfb-form-group\"><label for=\"vfb-field-663\" class=\"vfb-control-label\">Discipline<\/label><div><input id=\"vfb-field-663\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-663\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField669\"><label for=\"vfb-field-669\" class=\"vfb-control-label\">Is the nominee a CAMRT member?<\/label><div><div class=\"vfb-inline-group\"><div class=\"vfb-radio\"><label><input id=\"vfb-field-669-0\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-669\" value=\"Yes\">Yes<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-669-1\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-669\" value=\"No\">No<\/label><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><h2 class=\"\">Submitted by<\/h2><span class=\"vfb-help-block\"><h2><\/h2><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField664\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField665\"><div class=\"vfb-form-group\"><label for=\"vfb-field-665\" class=\"vfb-control-label\">Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-665\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-665\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField666\"><div class=\"vfb-form-group\"><label for=\"vfb-field-666\" class=\"vfb-control-label\">Member no.<\/label><div><input id=\"vfb-field-666\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-666\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-phone\" id=\"vfbField786\"><div class=\"vfb-form-group\"><label for=\"vfb-field-786\" class=\"vfb-control-label\">Telephone during the day<\/label><div><input id=\"vfb-field-786\" class=\"vfb-form-control vfb-intl-phone\" placeholder=\"\" data-default-country=\"ca\" data-hide-flags=\"1\" type=\"tel\" name=\"vfb-field-786\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField668\"><div class=\"vfb-form-group\"><label for=\"vfb-field-668\" class=\"vfb-control-label\">Your Email <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-668\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-668\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField1410\"><label for=\"vfb-field-1410\" class=\"vfb-control-label\">Do you give CAMRT permission to disclose your name as nominator to the nominee if requested?<\/label><div><div class=\"vfb-inline-group\"><div class=\"vfb-radio\"><label><input id=\"vfb-field-1410-0\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-1410\" value=\"Yes\">Yes<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-1410-1\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-1410\" value=\"No\">No<\/label><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField670\"><div class=\"vfb-form-group\"><label for=\"vfb-field-670\" class=\"vfb-control-label\"><\/label><div class=\"\"><h2>Judging Criteria<\/h2>\n<p>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\u2019s CV.<\/p>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField671\"><div class=\"vfb-form-group\"><label for=\"vfb-field-671\" class=\"vfb-control-label\">What has the nominee done to promote the profession nationally and\/or internationally?<\/label><div><textarea id=\"vfb-field-671\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"250\" rows=\"10\" name=\"vfb-field-671\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField672\"><div class=\"vfb-form-group\"><label for=\"vfb-field-672\" class=\"vfb-control-label\">Does the nominee\u2019s 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. <\/label><div><textarea id=\"vfb-field-672\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"250\" rows=\"10\" name=\"vfb-field-672\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField673\"><div class=\"vfb-form-group\"><label for=\"vfb-field-673\" class=\"vfb-control-label\">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.<\/label><div><textarea id=\"vfb-field-673\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"250\" rows=\"10\" name=\"vfb-field-673\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField674\"><div class=\"vfb-form-group\"><label for=\"vfb-field-674\" class=\"vfb-control-label\">Has the nominee made regular contributions to the CAMRT? For example, on an annual or bi-annual basis. Please provide examples.<\/label><div><textarea id=\"vfb-field-674\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"250\" rows=\"10\" name=\"vfb-field-674\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField675\"><div class=\"vfb-form-group\"><label for=\"vfb-field-675\" class=\"vfb-control-label\">Is the nominee recognized as a leader in the profession? Please explain.<\/label><div><textarea id=\"vfb-field-675\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"250\" rows=\"10\" name=\"vfb-field-675\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField676\"><div class=\"vfb-form-group\"><label for=\"vfb-field-676\" class=\"vfb-control-label\">Are there other noteworthy accomplishments by this nominee that should be mentioned? Limit response to 400 words.<\/label><div><textarea id=\"vfb-field-676\" class=\"vfb-form-control\" placeholder=\"\" data-vfb-maxwords=\"400\" rows=\"10\" name=\"vfb-field-676\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField677\"><div class=\"vfb-form-group\"><label for=\"vfb-field-677\" class=\"vfb-control-label\">If available, also include a copy of the nominee's curriculum vitae (Word or PDF format).<\/label><div class=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField678\"><div class=\"vfb-form-group\"><label for=\"vfb-field-678\" class=\"vfb-control-label\">Attachment<\/label><div><input id=\"vfb-field-678\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" type=\"file\" name=\"vfb-field-678\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-captcha\" id=\"vfbField679\"><div class=\"vfb-form-group\"><label for=\"vfb-field-679\" class=\"vfb-control-label\">Captcha <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"g-recaptcha\" data-sitekey=\"6LeCzgQTAAAAADGFLVMOmxoly8EjQ6zJRihRJqbX\"><\/div><input type=\"hidden\" name=\"_vfb_recaptcha_enabled\" value=\"1\" id=\"\"><div class=\"vfb-has-error\" id=\"vfb-recaptcha-error\"><span class=\"vfb-help-block\">reCAPTCHA is required.<\/span><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField680\"><button id=\"vfb-field-680\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField1952\"><div class=\"vfb-form-group\"><label for=\"vfb-field-1952\" class=\"vfb-control-label\">Text<\/label><div><input id=\"vfb-field-1952\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-1952\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField1953\"><div class=\"vfb-form-group\"><label for=\"vfb-field-1953\" class=\"vfb-control-label\">Textarea<\/label><div><textarea id=\"vfb-field-1953\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-1953\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":30,"featured_media":0,"parent":47038,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-7351","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/pages\/7351","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/users\/30"}],"replies":[{"embeddable":true,"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/comments?post=7351"}],"version-history":[{"count":0,"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/pages\/7351\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/pages\/47038"}],"wp:attachment":[{"href":"https:\/\/camrt.ca\/fr\/wp-json\/wp\/v2\/media?parent=7351"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}