Member Nomination

Name of the BSUG member/members Nominating:

PrefixFirst NameLast Name
Place of Work
Organisation
Email
example@example.com
Details of BSUG Member being Nominated:

PrefixFirst NameLast Name
Place of Work
Organisation
Email
example@example.com
NOMINATION FORM FOR BSUG LIFETIME ACHIEVEMENT

PLEASE COMPLETE EACH SECTION AS EACH SECTION WILL BE SCORED – Maximum of 100 words per answer.
1. Outline the contribution your nominee has made to the BSUG (eg: served on committees and their role during their tenure)
2. Outline the contribution your nominee has made to urogynaecology (eg: scientific work, publications, charity work)
3. Anything else you wish to add about the nominee in support of this nomination (eg: their contribution to the NHS)
Should be Empty: