Basic InformationName* First Last Degree(s) Your Title:* Your Institution* Your Email* Name of Nominee:* Nominee's institution:* Nominee's Title:* Nominee's email address* Short EssaysPlease write about one paragraph on each of the following:Please describe the nominee's approach to teaching (their personal philosophy of teaching).*Please describe something the nominee learned as a result of one of the educational development programs (such as the annual Surgical Education Week, Surgeons as Educators, or other programs) that they have attended that has changed the way they teach.Please describe the nominee's scholarly work in surgical education including: teaching activities, curricular development, evaluation and assessment innovations, research, etc.*Please describe a rewarding relationship the nominee had with a mentee including what they worked on and why it was gratifying.Additional InformationPlease list the education leadership roles (eg, program director, skills lab director, etc) that the nominee has or has had within their own institution.*Please list the educational leadership roles (chair or co-chair of a committee, other formal leadership title) the nominee has or has had in any national and international education-related organizations.*Please list any education awards or honors that the nominee has received.File uploads:CV*Max. file size: 512 MB.Please upload a letter of nomination by a resident, faculty, education administrator, or anyone else with knowledge of the nominee's teaching and educational scholarship.*Accepted file types: pdf, Max. file size: 512 MB.Please combine letters in to one file. Please upload no more than 2 letter(s) of support from leaders in education-related national/international organizations to demonstrate nominee's impact on surgical education.*Accepted file types: pdf, Max. file size: 512 MB.Please combine letters in to one file. Please upload no more than 2 letter(s) of support from individuals mentored by the nominee.*Accepted file types: pdf, Max. file size: 512 MB.Please combine letters in to one file. Please upload documentation of teaching excellence in the form of an aggregate evaluation report (from MedHub, New Innovations, etc) from learners over the past 6 - 12 months.*Accepted file types: pdf, Max. file size: 512 MB.Please combine documentation in to one file.