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Select whether you are applying on behalf of your own team or nominating another team
For the team to be eligible, it must comprise of 3 or more members
Nominators name | Email address | Work address
Preferred phone number of team lead. Can be a mobile.
Hospital, university, company etc. List multiple if necessary. We do not need the address
Please leave blank if you can't find it
Describe the work undertaken by this team in up to 500 words. Highlight how this work has benefitted patients, or the IPEM community. Please describe the work clearly in lay terms, in addition to any scientific/technical content:
Please ensure that this section is completed in detail as it, together with the submitted evidence below, will be used to determine winning applications. Refer to the award guidance notes for further information.
Refer to the award guidance notes for further information.