The Award may be given annually to up to 6 individual private practice prosthodontists (one per ACP United States and International Region) who have made outstanding contributions to the advancement of the specialty of prosthodontics, through prosthodontic practice, enhancing the public's understanding of the role of a private practice prosthodontist in comprehensive oral health care as well as exemplifying collegiality and cross discipline outreach, and/or exemplary community service. The award is a lifetime award and an individual may receive it only once.

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* 1. Please provide the NOMINEE contact information below.

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* 2. NOMINATOR please provide your contact information below.

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* 3. Please upload a letter or recommendation from a prosthodontist ACP member peer. (This can be from the nominator.)

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* 4. Please upload a letter of recommendation from a referring dentist. (Office managers can assist with this request.)

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* 5. Please upload a letter of recommendation from a dental org leader, lab technician or patient. (Office managers can assist with this request.)

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