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Nomination: The OSHP Residency Program Director Award
The OSHP Residency Program Director Award

To assist the Professional Affairs Division in evaluating the candidate for the proposed award, please provide the following information. CV's will NOT be accepted in lieu of this form.
Please provide the following information on the nominator.
Please note that you will NOT receive an email confirming your submission, but you should see an on-screen confirmation, including a submission number.

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