Once you hit submit, your score will be submitted and this page will refresh to show a blank form. Please submit a score for each application in the award category. Name of Reviewer(Required)Your name First Last Name of Applicant(Required)Name of the application you are scoring First Last Score Each Category:Score the applicant on a scale of 1-5, with 1 being the lowest and 5 being the highest score. Evidence of creativity, expertise, and/or commitment to their work within the Surgery Clerkship Program(Required)12345Leadership inside and/or outside their institution, including activities in professional organizations related to medical student education(Required)12345Evidence of commitment to the education of peers through presentations or other active roles within their institution and/or the Association for Surgical Education (ASE)(Required)12345Strength of LOR(Required)12345Additional Comments or Feedback for the Awards CommitteePhoneThis field is for validation purposes and should be left unchanged.