Zeshan Qureshi Award for Outstanding Contribution to Medical Education – Entry Form

The “Zeshan Qureshi Award for Outstanding Achievement in Medical Education” was launched in 2014. It aims to acknowledge the efforts of junior doctors and medical students, who in their spare time, have been setting up and contributing to projects to help their fellow students.

If you would like to enter, please fill in the form below. There is a £25 entry fee for administration purposes, payment for which will be taken through PayPal’s secure servers.

Personal Details

Please use the email you would like confirmation of your entry payment sent to from PayPal.


Please submit a 1000 word summary of your contributions to medical education*

Entries will be marked equally on i) overcoming obstacles/challenges ii) innovation of ideas iii) breadth of contributions and iv) impact of work.

Attachments

Files will be uploaded when you submit the application form, please ensure that your photo is no more than 5MB and your documentation is no more than 2MB.


Upload a high resolution photograph of yourself*
Acceptable file types: gif, png, jpg


Upload an up to date C.V*
Acceptable file types: pdf, doc, docx


Application Declaration

By submitting this application, I confirm that the submission and attached documents are of my own work as an individual and that all details are correct to my understanding.

Clicking Submit will upload your attachments and take you to PayPal to pay the entry fee. Your entry will be sent to us at the same time.

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