HIMSS Ontario Chapter by eYhL5doH


									To Ontario Healthcare IT/IS Executives
 Nominate a member of your organization’s staff for a special award!

HIMSS Ontario Chapter will provide a travel grant
    for the Winner to attend the HIMSS 2008
  conference, February 24-28, 2008 in Orlando,
                 Florida, USA
     (travel grant will reimburse member rate conference registration fee, economy travel and hotel
                                accommodation up to value of $2500 Can$)

                             Travel grant recipient to be announced at
                  HIMSS Annual General Meeting,
        June 21, 2007 Estates of Sunnybrook, Toronto, Ont.

Eligibility Criteria:
     Applicant must agree to pay for an active membership in HIMSS if not already a member
     Applicant must be employed in a health care provider organization in an Information
         Systems or Informatics-related role
     Applicant must be available to use the travel grant towards attendance at the HIMSS
         Annual Conference February 24-28, 2008 in Orlando, Florida, USA
     Applicant must have valid passport for travel to the USA during the conference time frame

Award Criteria:
    Winner will be chosen by lottery from the pool of eligible applicants
    Preference will be given to applicant who has not attended the HIMSS Annual conference
      within the last three years
    Award recipient to be chosen at the HIMSS Ontario Chapter Annual General Meeting, June
      21, 2007 in Toronto, Ontario.

Please submit application form via email to president@ontariohimss.org
by Friday June 1, 2007
     Award Application Form

Healthcare IT/IS Executive Name:

Healthcare IT/IS Executive Position:

Healthcare IT/IS Executive Contact number:

Healthcare Organization Name:

Healthcare Organization Address:

Award Applicant Name:

Award Applicant Position:

Award Applicant Contact number:

Year last attended HIMSS Conference:         HIMSS Member Number (if applicable):

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