PURPOSE
This award was established in 1994 to honor the memory of Dr. Gerald S. Wong, an advocate of the highest standard in diabetes care and education. The award is bestowed on a physician in recognition for significant contribution to the diabetes community.

ELIGIBILITY
A nominee must:
  • Be a physician;
  • Have demonstrated long standing and dedicated service to the diabetes community; and
  • Have performed service in the form of clinical care, teaching, advocacy, research or a combination of these.

Question Title

* 1. Nominator's Full Name

Question Title

* 2. Nominator's Email Address

Question Title

* 3. Nominee Full Name

Question Title

* 4. Nominee's Email Address

Question Title

* 5. Nominee's Title

Question Title

* 6. Nominee's Institution

Question Title

* 7. Explain why the applicant deserves the Gerald S. Wong Award. (500 word count single spaced)

Question Title

* 8. Please upload the first letter of recommendation.

PDF, DOC, DOCX file types only.
Choose File

Question Title

* 9. Please upload the second letter of recommendation.

PDF, DOC, DOCX file types only.
Choose File

Question Title

* 10. Please submit the nominee's resume

PDF, DOC, DOCX file types only.
Choose File

Question Title

* 11. Do you have any additional comments?

Unless otherwise noted, Diabetes Canada will use the data collected for analytical purposes to determine what services we can provide to better understand and manage diabetes. Identifiable information will only be collected with your consent and unless otherwise notified will not be shared other than with Diabetes Canada or its affiliates who may complete data analysis on Diabetes Canada’s behalf.

By providing your contact information you are permitting Diabetes Canada to contact you.

T