AWARDS
GDHA OUTSTANDING DENTIST OF THE YEAR
Outstanding Dentist of the Year Award application.docx.
Outstanding Dentist of the Year Awardapplication.pdf
The GEORGIA DENTAL HYGIENISTS’ ASSOCIATION offers this award to a Georgia dentist who has shown exemplary respect and support of the dental hygiene community
Criteria: nominations must come from a GDHA hygienist and the nominee must be a licensed Georgia dentist.
Nominee’s Name ____________________________________________________
Nominee’s Address _______________________________________________________
________________________________________________________________________
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Nominator’s Name ____________________________________________________
ADHA # __________
Nominator’s Address _______________________________________________________
_________________________________________________________________________
Contact # _________________________________________________________________
Email Address _____________________________________________________________
Relationship to the Nominee __________________________________________________
Please explain, in 200 words or less, why you are nominating this individual for this award. Please include humanitarian efforts, hobbies, personal/professional awards/accolades and how this individual has shown support for the profession of dental hygiene.
Return completed nomination to the GDHA Awards Chair, Barbara Harrison at: bhdh72@bellsouth.net
Georgia Dental Hygienists' Association Outstanding
G.D.H.A. Volunteer of the Year
Name: ______________________________________________________________________
Address: ______________________________________________________________________
______________________________________________________________________
Contact Number: (_______) ___________________________Cell or Home (circle one)
Work Phone: (_______) ___________________________________
Component: ________________________________________________________
Nominated by: ______________________________________________________
Comments: Write a brief narrative explaining the reasons for nominating the candidate for this award. The award is based on the current years’ service. Please be as specific as possible in the narrative explaining the service of the candidate.
A nominee information form will be forwarded to the candidate upon receipt of this form.
Deadline for submission is two months before the GDHA Annual Conference
Return completed form to the VOTY Awards Chair Barbara Harrison at: bhdh72@bellsouth.net