Outstanding Faculty Teacher Award Application

Deadline: Sunday, December 4, 2022

All fields are required.

First Name: Last Name:
Email Address:
Academic Rank:
Mailing Address:
Supporting Documents
Upload your CV:
Statement of Education Philosophy: 2-3 paragraphs written by applicant, limited to 1 page

Teaching Portfolio: please submit an outline form a Teaching Portfolio which describes your experience as a surgical educator/teacher. Please use this sample outline as a guideline for what should be included.

Teaching Excellence: Documentation of teaching excellence must be provided, which may include but is not limited to: teaching evaluation reports, dissemination of educational approaches and outcomes via presentations or publications, development of educational programs and media, and program evaluation reports.

Sponsor Letters - The letters must include examples of how the nominee has demonstrated the qualities listed above.
Program Director (or equivalent) nomination letter:
Resident/Fellow supporting letter:
Supporting Letter 2:

American Council of Academic Plastic Surgeons
500 Cummings Center, Suite 4400, Beverly, MA 01915
Phone: 978-927-8330 | Fax: 978-524-0498