FPM President's Medal Nomination Form 2021

FPM President's Medal 2021

Nomination form
Your details and the details of your nominee
Please enter your name*

PrefixFirst NameLast Name
Please enter your email address*
example@example.com
Please enter your membership number (if known):
Please enter the name of the person (or team) that you are nominating for the FPM President's Medal*
Name (e.g. Dr Jess Smith/Discovery Team, Company Name)
Please enter their contact email address*
example@example.com
If successful, FPM can let my nominee know that I have nominated them for this award*

YesNo

Nomination statement
The FPM President's Medal is the highest award that FPM bestows. This award recognises exceptional individuals who have gone above and beyond to deliver fundamental and transformational change to the field of pharmaceutical medicine.

The nature of contribution which qualifies has been kept deliberately broad, but it must be a contribution that has advanced the practice of pharmaceutical medicine.

The award is open to members and non-members of FPM. Nominees do not need to be medically qualified. The award is typically made to an individual, however nominations for a team will also be considered.

The Fellowship and Awards Committee review all nominations on a case-by-case basis. Only the information submitted below will be considered. Therefore, please think carefully about you statement in support of nomination. Please note there is a minimum word count of 300 words.
Please enter your statement in support of your nomination for the FPM President's Medal*
min. 300 words, max. 1000 words

Consent for FPM announcements
Should your nomination be successful, we would like to use your supporting statement and name in the announcement of the award. This may include our webpages and LinkedIn & Twitter accounts (e.g. our Awards 2020), as well as emails to members.

We will ask for their permission first, and if they say "yes" we would like to use your name and nomination text for this.
Would this be ok?*
Thank you for your nomination.

We will email you to let you know if your nomination has been successful after the Fellowship and Awards Committee meeting in early May 2021.

Unfortunately we cannot email everyone who has submitted an unsuccessful nomination.
Should be Empty:

FPM President's Medal 2021