Distinguished Dental Alumni Award 2017
NOMINATION FORM

University of Minnesota School of Dentistry Alumni Society

DIRECTIONS FOR FILLING OUT THIS NOMINATION FORM

Please read the criteria listed below carefully and provide only the pertinent information requested.

Attachments should be 3-5 pages in length. Please note that attachments that exceed 5 pages will not be accepted for committee review.

Submit the completed form by December 08, 2017. You can direct any questions to:

Erin Elliott, School of Dentistry Alumni Society
15-136 Moos Tower
515 Delaware Street SE
Minneapolis MN 55455
612-626-6884
estrong@umn.edu

Criteria for Judging Distinguished Dental Alumnus Award

1. Candidate must hold a DDS and be a graduate of the University of Minnesota School of Dentistry dental program or one of the graduate or specialty programs.

2. Participation, service, and leadership in the advancement of dentistry and dental health at the local, state, national level, or international level.

3. Participation and leadership in public service, community service, and/or civic affairs at the local, state, national level, or international level.

4. Participation and leadership in continuing education through study clubs and postgraduate courses, lectures, publications, research and/or teaching.

5. Dedication to the highest standards in the profession of dentistry.

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