Nomination Form for Fellowship Without Examination 2018

NOMINATION FORM FOR FELLOWSHIP WITHOUT EXAMINATION – 2018

i)Any Fellow of the College in good standing(i.e. have no outstanding membership fees) may propose nominations to the Fellowship without Examination.

ii)The form must state in detail the reasons for nomination, with specific reference to the significant contributions made by the nominee in the UK. Please refer to the guidance before completing this form and ensure that the nomination and applicant’s CV meet the criteria.

iii)The completed form must be accompanied by the nominee’sten page CV.Only the first ten pagesof any CV receivedwill be submitted to the committee.

iv)The nomination must be supported bytwo Fellows of the Collegein addition to the nominator. At least one of these three Fellows should work at an institution different to the nominee.All three Fellows must be members of the College in good standing. Details of the nominator and supporters are subject to verification.

v)The completed nomination form, accompanied by the nominee's ten page CV, should be sent to Ms Ruth Gibson, Curriculum and Equivalence Officer at the RCR. The closing date is Thursday 29 March 2018 at 5.00pm.Nominations received after this time will not be accepted.Nominations may be posted or sent by e-mail to Ruth Gibson.

vi)Nominations are considered by the Fellowship Assessment Committee and Council. The outcome of nominations will be confirmed as soon as possible after the Council meeting in July 2018. In the case of successful nominations, confirmation will be sent to the nominee and the nominating Fellow; in the case of unsuccessful nominations, to the nominating Fellow only.

vii)If you have any queries, please contactRuth Gibson by email or on0207 406 5955.

NOMINATION FOR FELLOWSHIP WITHOUT EXAMINATION –2018

Please read the guidance before completing this form

1.I nominate the following for the award of Fellowship without Examination:

(Nominee’s FULL name)

of

(Main place of work)

on the following grounds:(please limit to the space provided on this page and specify how the applicant has demonstrated a significant contribution to training or practice in the UK, as set out in the guidance).

2.This nomination is supported by two Fellows of the RCR, whose full names and contact details appear below. (These must be in addition to the nominator. At least one of the three Fellows supporting this nomination should work at an institution differentto the nominee. Allthree Fellows must be in good standing with the RCR).

(Full name of first Fellow – please print clearly)(Email address)

(Full name of second Fellow – please print clearly)(Email address)

3.Chief Executive (or equivalent) of the nominee's main place of work.The Warden of the Fellowship may contact this individual about this nomination.

(Title)(Full Name)

(Job Title)

(Full Postal Address)

(Telephone Number)(Email address)

4.I enclose the nominee’s CV. (The CV must be limited to ten pages)

5.Nominator’s details:

(Full name of nominating Fellow) (Nominator’s email address)

(Full Address of nominating Fellow)

(Telephone Number)

(Date)

Details of the nominator and supporters are subject to verification.

The closing date is Thursday 29 March 2018 at 5.00pm.

Nominations received after this time will not be accepted.

The nomination form with CVmay be sent by e-mail toRuth Gibson or by post to

Ms Ruth Gibson,

Curriculum and Equivalence Officer

The Royal College of Radiologists

63 Lincoln’s Inn Fields

LONDON

WC2A 3JW

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