R. Tait McKenzie Award of Honour - 2018 Nomination Form

Candidate Information
Current Position
Previous Position 1
Previous Position 2
First Nominator
Second Nominator
Third Nominator

Please provide a brief biographical sketch which describes the background and accomplishments of the nominee and how they meet the selection criteria of this award. Maximum of 500 words.

Letters of Reference

All letters must be signed by the referee.

Supporting Documentation

Please attach any supporting documentation for this nomination (maximum 5 pages).

All letters and supporting documentation not attached to this submission must be received by the PHE Canada office by the nomination deadline.