Clone of 2026 Resident Award Nominations

Clone of 2026 Resident Award Nominations

2026 Georgia Academy of Family Physicians Resident of the Year Nominations
Name*

First NameLast NameSuffix
Email*
example@example.com
AAFP ID #
Resident Award

Family Medicine Resident of the Year

A candidate for the award will be a deserving GAFP resident member who has been a leader in academic, community and professional affairs, along with making an outstanding contribution to the profession or the community.

Candidates will be evaluated on the following:
1. Member of the GAFP in good standing, holding membership at least one year prior to the year of selection
2. Completed general nomination form.
3. Current Curriculum Vitate submitted by the nominator
4. Must be in a Georgia Residency Program
5. Qualifications to be considered are: Academic, Clinical Expertise, Community Involement, Involvement in the Discipline of Family Medicine and Involvement in Academy Activities.
Deadline to submit nominations is Friday, April 17, 2025.
Name of Nominee
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Residency Program
Year of Residency

Outline the Candidate's Qualifications in the Following Areas:
Academic:
Community Involvement
Clinical Expertise

Involvement in the Discipline of Family Medicine:
Involvement in Academy Activities:
Program Director

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Honors/Graduation Program Date
Email
example@example.com

Current CV

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Nomination Letter

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* Keith Ellis Nomination Letter from Program Director

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