Member of the Year Nomination - Minnesota Dental Hygienists Association

Who is the member you would like to nominate?

First Name *

Last Name *

Currrent Component and Position *

Nominating member's contact info

First Name *

Credentials *

Phone Number

Last Name *

Email

Address

Criteria: Please comment on the outstanding achievements of this member in some or all of these areas. This award represents achievements as a dental hygienist both within the Association and out. Due to the nature of this recognition, unless comments are made on at least some of the below criteria, this nomination is null and void.

Responsibility *

Attitude *

Initiative *

Leadership *

Additional Comments

Members nominated will be notified, and asked to complete the Curriculum Vitae as part of the nomination process.

Member of the Year Nomination Form