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2023 ICEP Awards Nomination Submission Form

ICEP Award Nomination Submission Form

Please complete the following submission form with ALL required information before submitting.
 

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Award Nomination Submission Form
ICEP recognizes its dedicated leaders with three awards, presented each year at the Ginny Kennedy Palys Annual Symposium (effective 2023), formerly known as the Spring Symposium and Annual Business Meeting.

Please consider nominating a colleague for one of ICEP’s awards:
  • Bill B. Smiley Award – ICEP’s highest award that recognizes a member for a lifetime of service to ICEP and emergency medicine in Illinois.
  • ICEP Meritorious Service Award – This award is conferred on a member who has made a special contribution to ICEP through service, advocacy, education, or other contributions.
  • Downstate Member Service Award – This award recognizes the contributions of a member who lives and works outside the metropolitan Chicago area.
All Award Criteria
Must be an ACEP and ICEP member in good standing.

Nomination Submission Package
All nominations must include the following:
  • Candidate’s CV/Resume
  • Photo/headshot of candidate
  • Cover letter explaining the candidate’s nomination. (2 pages max)
  • If nominating a candidate for multiple awards, separate cover letters must be sent in support each award nomination must be submitted via the online form.
1. What award would like you like to submit a nomination for? *This question is required.
This question requires a valid email address.
This question requires a valid email address.
6. Please upload your nomination letter in support of the nominee in a PDF Format (preffered). The letter should not exceed 2 pages.

  *This question is required.
7. Please upload the nominee's CV/Resume in a PDF Format (preferred). *This question is required.
8. Please upload the nominee's headshot/photo (optional).