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Award Nomination Form
Nomination Form (To be filled by Nominator)
Full name of Individual you wish to nominate*
Organization of the nominee*
Email address of the Nominee*
Category of Award*
EM Leader
ESEM Best EM Physician Award
ESEM Best EM Nurse Award
ESEM Best Paramedic Award
ESEM Best EM Educator Award
ESEM Best EM Researcher
ESEM Best EM Resident Award
Nominator Details
First Name*
Last Name*
Email Address*
Please upload support letter highlighting the nominee’s contribution towards EM Community and Emirates Society of Emergency Medicine.*
Any other document to Support Nominee
Submit