NOMINATION SUBMISSION

This award recognizes rural College of Medicine (CoM) faculty members who have created new, or adapted existing, tools, curriculum, or programs, for use in rural-focused teaching and learning. The award also recognizes demonstration of the CoM values.

🟧 Note: Self-nominations are not accepted. Please do not submit any additional materials - they will be removed from the nomination package prior to adjudication.

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* 1. Nominator Information

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* 2. Nominee Information

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* 3. Do you consent to this nomination package being shared with the nominee, whether or not they are the award recipient?

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* 4. Do you consent to being publicly recognized if your nominee is the successful recipient?

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* 5. Upload the Nomination Letter, which must be signed by at least 2 people:

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