STFM Innovative Program Award
I would like to nominate the following person(s) for
the 2008 STFM Innovative Program Award.
Nominee(s) ______________________________________________________
Institution ______________________________________________________
Address _______________________________________________________
City __________________________________________________________
State ___________________________________________
Zip ___________
Phone ______________________________ Fax ______________________
E-mail ________________________________________________________
The STFM Innovative Program Award is offered to honor
excellence in the development of an original educational program
or activity for family practice residents, students, or faculty
that has had a significant, positive impact on family medicine education.
Nominations Requirements (Deadline for receipt of
11 sets of the materials in the STFM office—October 1, 2007 ):
- A nominator who is an STFM member (Self-nomination is acceptable.)
- A statement from the nominator citing the nominee’s involvement
in the program or activity development, the program/activity’s
impact on improving resident, student, or faculty education, and
the regional or national significance of the program/activity
- Up to an additional three letters of support from individuals
familiar with the program or activity, whether participants, graduates,
or supervisors
- Appropriate program materials
- Curriculum vitae of the nominee(s)
Send 11 sets of the nomination materials to Traci Nolte,
STFM, 11400 Tomahawk Creek Parkway, Ste 540, Leawood, KS 66211.
800-274-2237, ext. 5420, e-mail: tnolte@stfm.org.
Nominator _____________________________________________________
Institution ______________________________________________________
Address _______________________________________________________
City __________________________________________________________
State ___________________________________________
Zip ___________
Phone ______________________________ Fax ______________________
E-mail ________________________________________________________
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