Please complete the below and submit electronically.

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* 1. Name of Candidate

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* 2. Position for which Candidate is running for:

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* 3. Please describe your relationship with the candidate:

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* 4. Candidate's contributions in neurovascular practice.

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* 5. Candidate's Leadership Ability.

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* 6. Candidate's Professional Communication.

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* 7. Candidate's Ability to Meet Deadlines.

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* 8. Candidate's Quality of Work.

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* 9. Candidate's Creativity and Innovation.

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* 10. Candidate's Accountability and Integrity.

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* 11. Your Name

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* 12. Email

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* 13. Please upload a Letter of Support for this candidate. 

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