Faculty of the Year Application

Academy of General Dentistry (AGD) Student Chapters are an important source of relevant, real-world information for today’s young dental professionals. Through guided events hosted by local AGD and student representatives as well as invited speakers, attendees can observe the latest dental techniques, receive valuable practice management advice, identify leadership opportunities within organized dentistry, achieve AGD Fellowship, and much more.

The Faculty of the Year Award honors one AGD Student Chapter Faculty Advisor who provides their chapter with the best overall support and guidance. The activities shared below will be directly considered for the award.

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* 1. Dental School/Chapter name:

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* 2. Is your Chapter in good standing by submitting the Student Chapter Registration/Renewal form to AGD Headquarters.

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* 3. Your Name:

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* 4. Your Email Address:

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* 5. Your Primary Phone Number:

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* 6. Name of the Faculty Advisor you’re nominating?

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* 7. Faculty Advisor's email:

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* 8. Faculty Advisor's phone:

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* 9. Is the Faculty Advisor an AGD member?

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* 10. How has this Faculty Advisor supported the AGD Student Chapter and/or encouraged students to join the AGD? Please explain.

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* 11. Please provide a description of the nominee’s specific attributes, accomplishments, and contributions to his/her AGD Student Chapter?

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* 12. Has this nominee made any personal investments or sacrifices for the success of his/her student chapter (i.e. time, finances, etc.)? Please explain.

Thank you for submitting a nomination for the AGD Faculty Advisor of the Year Award.  The winner will be notified in April 2019.

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