Nomination Form for the Graduate Medical Education Committee
Return form to:    GME, 100 CSN, MC 675    or     Fax: 312-996-3050
PRINT Name:
Program:
Email address:
Please provide a brief statement expressing your (or another nominee's) qualifications for and/or interest in serving on the GME Committee.  This statement will be distributed to all residents and fellows to assist them in voting for their resident representatives to the GME Committee. You may also submit your statement by email to gme@uic.edu .

Nomination statements must be received by noon on July 10 to be included in the election.