VDA FELLOWS - NOMINATIONS

Please use the form below to submit nominations for VDA Fellows. Nominations are accepted through May 15 for awards given at the VDA Annual Session in September.

Your Full Name *

Nominee Name *

Dental School Nominee Attended *

Graduation Year *

VDA Member as of (date): *

When did the nominee serve as a VDA Alternate Delegate?

When did the nominee serve as a VDA Delegate?

Other VDA Activities/Offices/Committee Positions Held:

Component Activities/Offices/Committee Positions Held:

Volunteer Service

Upload the Nominee's CV

Why do you feel this person should be a VDA Fellow?