Sunstar/RDH Award of Distinction 2014

1. Default Section

Question Title

* 1. If you are nominating a colleague, please enter your contact information below. If this is a self-nomination, you do not need to enter the information again.

Name:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

Question Title

* 2. If this is a self-nomination, please enter your contact information below. If you are nominating a colleague, please enter his or her contact information below.

Name:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

Question Title

* 3. How long ago did the nominee (or you if you're nominating yourself) graduate from hygiene school?

Less than 5 years

5 to 10

10 to 15

15 to 25

Over 25 years

Question Title

* 4. Are you nominating yourself for the award, or are you nominating a colleague?

Self-nomination

Colleague

Question Title

* 5. How did you hear about this award program?

RDH Magazine

RDH eVillage Newsletter

RDHMag.com

Email from RDH Magazine

Hygiene Community

Question Title

* 6. In which category has the applicant achieved his or her greatest accomplishment? (choose one category)

Education

Community Service

Private Practice

Question Title

* 7. How has the applicant assisted his or her patients in living a healthier life?

Question Title

* 8. How has the applicant made a positive impact on their community?

Question Title

* 9. When in private practice, what has been the applicant's greatest achievement?

Question Title

* 10. Of what accomplishment in the applicant's hygiene career are they the most proud?

Award of Distinction Eligibility Guidelines

The Sunstar / RDH Award of Distinction application is open only to licensed dental hygienists. To be eligible the entrant must have an active dental hygiene license in the United States or Canada.

The entrant cannot be a full time employee of a dental products distributor which markets products competing with the Sunstar Americas product line.

Each recipient will be required to sign a Confidentiality Agreement and Release Form, prior to any photo session or participation in dental focused discussion groups.

Judging will be conducted by prior Award of Distinction Recipients. News judges will be randomly selected each year.

Nominations will close at midnight central standard time on April 4, 2014.