2024 Future Leader Award Nomination Survey

PURPOSE - This award is designed to recognize a deserving Student Member (2024 graduate) who exhibits strong commitment to the dental hygiene profession and have demonstrated leadership within their student chapter and dental hygiene program.
CRITERIA
A. Quality of service to the Student Chapter and the local, state and/or national association levels.
B. Represent the association in a professional manner.
C. Community involvement and service to others (Dental or Non-Dental).
D. Interest in continued professional growth with FDHA and ADHA.
E. Enthusiastic about the profession of Dental Hygiene.
F. Acts in a professional manner with faculty and other students.
G. Agrees to serve as a member of the Student Committee (state level) for one year if chosen as the winner of the award.

1.Dental Hygiene Program submitting the nomination for the FDHA Future Leader Award. (Select only one) Each program may submit one nomination.(Required.)

2.Name of the person submitting the nomination? (For example, Jane Doe)(Required.)

3.What is your position in the Dental Hygiene Program (select all that apply)(Required.)

Student Advisor

Faculty

Program Administrator

4.What is the name of the FDHA Future Leader Award nominee? (For example: Jane Doe)(Required.)

5.Please confirm the student has/is graduated/graduating in 2024.(Required.)

6.Please confirm the student nominated has agreed to serve as a member of the Student Committee (state level) for one year if chosen as the winner of the award.(Required.)

Yes, the student nominated has agreed

No, the student nominated has not agreed (this will disqualify them for this award)

7.Please confirm that you have sent the FDHA Awards Manager (Emily Anderson administrator@fdha.org) the Nominating Letter. (Select only one)(Required.)

Yes, I have submitted the Nominating letter

No, I have not submitted the Nominating Letter. Note: the nomination will not be considered if not received by June 30th.

8.As the nominator, confirm that you notified the nominee of this nomination; and provided the date of the Awards Ceremony where the award winner will be announced.(Required.)

Yes, I have notified the nominee of this nomination; and the date of Awards Ceremony.

No, I have not notified the nominee of this nomination; and the date of Awards Ceremony. I understand this is my responsibility to the nominee.

9.What is the best email address to reach you?(Required.)

10.What is the best phone number to reach you?(Required.)

Current Progress,

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