CDA Member AwardsNomination Submission Form ENTRIES MUST BE RECEIVED BY MARCH 2, 2025 AwardWhich award will you be submitting a nomination for?(Required)Please selectPractitioner of the Year AwardLifetime Achievement AwardAward of MeritEarly-Career Volunteer AwardAward of HonourResearch Award in DermatologyResident's Writing AwardNominee InformationFull Name(Required)Email(Required)City(Required)Province(Required)AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonNominator InformationFull Name(Required)Your Email Address(Required) Email Address Confirm Email Address I wish to remain anonymous for my nomination Yes If self-nominating, I confirm that I am able to attend the 2025 CDA Annual Conference to present my research.June 18-21, 2025. Halifax, NS Conference registration fees will be covered by the CDA. I agree Publication DetailsTitle of Entry(Required)Date entry was published in the JCMS/JCMS Case Reports(Required)Must fall between: January 1 - December 31, 2024Entry Publishing Status(Required)Please SelectUnpublished researchResearch accepted for publicationPublished research (within the past calendar year)The study was designed and carried out by (or under supervision of) the nominee.(Required) I agree Supporting DocumentationPlease provide all documentation as per the award's terms of reference.Copy of the Written Work(Required)Max. file size: 3 MB.Description of the Entry(Required)Max. file size: 3 MB.Curriculum Vitae(Required)Max. file size: 3 MB.Letter of Nomination(Required)Max. file size: 3 MB.Letter(s) of Support(Required) Drop files here or Select files Max. file size: 3 MB, Max. files: 4. NameThis field is for validation purposes and should be left unchanged. Δ
