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* 1. Nominee Information

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

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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:

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