Medical Student Scholarships

Nominee's name*

First Last

CFPC membership number

if applicable

Address*

City*

Province*

Postal code*

Phone*

Email*

Is the nominee currently a fourth-year medical student at UBC?*

Is the nominee entering post-graduate family medicine training in Canada?*

Is the nominee aware of this nomination?*

Nominator's name*

First Last

CFPC membership number

if applicable

Address*

City*

Province*

Postal code*

Phone*

Email*

Nomination letter/supporting documents

Your nomination letter/supporting documents should include:

The reason for your nomination
A brief biography or resume of your candidate (i.e. educational and community profile)
Evidence of your candidate’s significant characteristics relevant to the award in the form of descriptive materials, testimonials or other documentation.

Other information that will help our Awards Committee make a decision. Supporting documents could include:

Letters of support, which may be from allied professionals, patients, community members or others positively impacted by the work of the nominee
Any other information which you feel will help the selection committee in its deliberations.

Valid upload file extensions: .doc, .docx, .pdf Maximum file upload size 64MB

Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 64 MB.

How did you hear about this award?*

If other, please specify e.g. a colleague, health authority.