2024 WDA Dental Excellence Awards Nomination

If you are nominating someone for the WDA Lifetime Achievement Award, please send a current copy of your nominee's curriculum vitae or resume to Amy Bastic at abastic@wda.org.

Nominations must be submitted by July 15 for consideration in the current calendar year.

Nominees who are not selected will NOT be automatically considered the following year, but may be nominated again.

Question Title

* 1. Nominee Information

First name

Last name

Day phone

Nominee's address

City

State

ZIP

Email address

Question Title

* 2. The above nominee meets the criteria for the following category: (descriptions online at wda.org/meetings/wda-president's-gala)

Lifetime Achievement (The WDA's highest honor; MUST include nominee's CV or resume)

Communications

Community Outreach

Friends of Dentistry

Media Awareness

New Dentist Leadership

Outstanding Leadership in Mentoring

Political Action

WDA Award of Honor

Question Title

* 3. Please provide a description of your nominee's contributions (250-word minimum required). Explain why you think this individual, or group of individuals, meets the criteria for the category indicated above.

Question Title

* 4. Submitted by:

Your first name

Last name

Day phone

Email address