PURPOSE - To identify grassroots members who have contributed to the profession of Dental Hygiene through service and dedication to component and/or state activities in the 2020-2021 year.

CRITERIA
1. Must be an active, voting member.
2. Include achievements between FDHA annual symposiums.
3. Candidate may be employed in any area of dental hygiene.
4. Consideration should not include present FDHA (state) officers. According to the FDHA Bylaws, Article IV, Sections 1, officers are defined as Line Officers, District Trustees, ADHA Delegates and Alternate Delegates, and Speaker of the House. 

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* 1. Component submitting the nomination for the FDHA Swann D. Knowles Achievement Award. (Select only one)

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* 2. What is the name and credentials of the award nominee? (For example: Jane Doe, CRDH)

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* 3. What is the award nominee's ADHA Membership ID? (number listed on the component alpha roster from ADHA)

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* 4. As the nominator, confirm that you have emailed the supporting documentation listed below to the FDHA Swann D. Knowles Achievement Award Chair, Candy Velez at velezcandym@gmail.com; and added a return receipt for delivery confirmation. (Select only one)

Supporting Documentation: 1) Nominating letter from another dental hygienist; 2) Letter of recommendation from the nominee's co-worker, patient, or employer; and 3) Letter explaining how the nominee meets the award criteria.

NOTE: You must submit all supporting documentation by June 30th for the nomination to be considered.

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* 5. As the nominator, confirm that 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.

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* 6. What is the name and title of the Component officer submitting the award nominee's name? (For example, Jane Doe - President)

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

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

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