2024 WDA Pyramid of Pride Award Nomination

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* 1. Nominee Information

First name

Last name

Day phone

Nominee's address

City

State

ZIP

Email address

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* 2. The above nominee meets the criteria for the following category (descriptions online): https://www.wda.org/meetings-events/pyramid-of-pride-awards (check only one):

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

Community Outreach

Friends of Dentistry

Communications

Media Awareness

New Dentist Leadership

Outstanding Leadership in Mentoring

Political Action

WDA Award of Honor

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* 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.

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* 4. Submitted by:

Your first name

Last name

Day phone

Email address