2025 Junior Fellow Nomination Form

Nomination Deadline:

The ISMRM Junior Fellow Program was established to recognize outstanding researchers at an early stage in their careers, with an established and long-term commitment to the ISMRM. Junior Fellowship may be maintained for up to ten (10) years as long as ISMRM membership remains current.

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Nominator's Contact Information

Nominator's Member ID Number

Nominator's Name*

First Last

Nominator's Email*

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Supervisor's Form

The nominee's supervisor must complete an additional form about the nominee.

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Nominee's Details

Nominee's ISMRM Member ID Number*

Nominee has been an ISMRM member since...

Honorific*

If Other, please enter here:

Nominee's Gender

How does the nominee identify?

Man

Woman

Prefer not to disclose

Prefer to self-describe

Enter preferred description here:*

Nominee's Name*

First Last

Nominee's Email*

We will contact the nominee at this address. Please be sure it is entered correctly and is their current preferred email address.

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Nominee's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nominee's Phone*

Nominee's Fax

Nominee's Degree Status

Highest Degree Awarded:

Date Highest Degree Awarded

Degree Focus

Clinical

Scientific

Abstract(s) Submitted by Nominee

If the nominee is the first author on any abstracts submitted to next year's Annual Meeting, please list the tracking ID numbers here.

Abstract Tracking Number(s)

Reminder: Supervisor's Form

Don't forget to complete the supervisor's form about the nominee! If we do not receive that, your nomination could be invalidated.

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