Aesculapius Awards
Fax response form to 301-320-0978 — page 1 of _____
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I'm interested in — please check all that apply
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Serving on the Award Advisory Board |
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Judging
the following entries: |
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Entering
the awards competition: |
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Promoting the Aesculapius Awards competition |
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Sponsoring the Aesculapius Awards program |
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Being kept informed about the Aesculapius Awards program |
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Nominating colleagues who would welcome being informed about the awards program — please attach colleagues' contact information! |
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Participating in some other way — please specify below |
Remarks/requests – if necessary, please attach additional sheets
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