Visiting Clinical Professorship Nomination Form

Thank you for your interest in the Visiting Clinical Professorship. Please fill out the required information below.

PLEASE ENSURE ALL ATTACHMENT FILE NAMES DO NOT CONTAIN SPECIAL CHARACTERS. This includes but is not limited to  ! * # ; ? \ / : " < > |.

PLEASE NOTE that you must submit the online application, in one single step; you are not able to save your application and return to it at a future date, rather it must be completed all at one time.

Nominator's Information

 

Nominee's Information

 

Required Documentation

Note: Files must be in .pdf format.

Please click on the "Submit" button to submit your nomination form for the Visiting Clinical Professorship. Before submitting, please ensure you have filled out all of the mandatory fields and all attachments are correct.

Upon successful submission you will be directed to a webpage that confirms the successful submission and within a short period of time you will receive an email from the CAG National Office confirming receipt of your submission.  If this does not occur, please contact the CAG National Office.

NOTE: Upon submission do not close your browser or use the back button until the Thank You screen appears confirming your submission has been successful. Uploading of large files may take a minute or more.