PURPOSE - This award is presented to individuals who have contributed outstanding services in the field of Dental Hygiene in Florida.

CRITERIA
A.   Length and quality of service to FDHA including local, district and national levels.
B.   Length and quality of practice in Florida.
C.   Accomplishments.
D.   Offices held (local, district, national).
E.   Continued dedication and commitment to FDHA and to the profession of dental hygiene
F.    Must be a voting member of FDHA/ADHA.
G.   Awarded once per member per lifetime.

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* 1. What is your name and credentials as the person submitting the nomination for the FDHA Distinguished Service Award. (For example: Jane Doe, CRDH)

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* 2. What is your ADHA Membership ID? (locate the number on the ADHA website under Member login)

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* 3. What is the name and credentials of the member you are nominating for the FDHA Distinguished Service Award? (For example: Jane Doe, CRDH)

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* 4. As the nominator, confirm you emailed the letter of nomination to the Distinguished Service Award Chair, Rhoda Kublickis at rhokub@msn.com; and added a return receipt for delivery confirmation. (Select only one)

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* 5. As the nominator, confirm you notified the nominee of this nomination; and provided the date of the Awards Ceremony (10/1/21 at 6pm) where the award winner will be announced. (Select only one)

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* 6. What is the best email address to reach you?

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* 7. What is the best phone number to reach you?

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