Award Selection

The Clerkship Directors in Emergency Medicine (CDEM) presents two new awards for Clerkship Directors and Clerkship Coordinators. The Clerkship Director Longevity Award and the Clerkship Coordinator Longevity Award will be presented to individuals in their respective positions that have achieved 5-10-15-20-25-30 years of service. There is no nomination process for these awards, but rather, if an individual fits the criteria of the award, they may complete the below form to receive a certificate.

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* 1. Please select an award.

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* 2. Enter the candidate's full name (eg. John Smith, MD).

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* 3. Enter the candidate's institution.

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* 4. Enter the candidate's email address.

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* 5. Current position title

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* 6. Number of Years in position

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* 7. Anniversary date

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* 8. If you are nominating someone else, please enter your name and email address.

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* 9. Upload a high resolution photo of the candidate.

PNG, JPG, JPEG, GIF file types only.
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