2022 Awards Nomination Form
  • Florida Dental Association Annual Awards Call for Nominations*

    *Submission of a nomination(s) is not a guarantee that an award will be given annually.
  • INSTRUCTIONS: Complete the application section below. Nominations will be reviewed by selected members of FDA leadership bodies. Recipients will be notified in November 2021 and can receive the physical award at the annual Awards Event held in conjunction with the 2022 Florida Dental Convention in June. NOTE: Members of the FDA Board of Trustees are not eligible to receive the leadership award.

    PLEASE REVIEW THE SPECIFIC CRITERIA BELOW FOR YOUR NOMINEE; we cannot accept nominations that don't meet the criteria.

    DEADLINE: All nominations must be received by Tuesday, Sept. 14, 2021.

    AWARD CRITERIA:

    Dental Team Member Award
    Number Awarded: Up to 1
    Eligibility: Any team member of a member dentist in good standing
    Nominators: Any member dentist
    Criteria: Demonstrates dedicated effort and outstanding accomplishments both within the dental team as well as public outreach and volunteerism
    __________________________________________________________________________

    Public Service Award

    Number Awarded: Up to 3
    Eligibility: Any individual, organization or corporation
    Nominators: Any FDA member in good standing, district or affiliate
    Criteria: Performed extraordinary acts of charitable service related to oral health that have left an indelible mark on the individuals, groups or communities it touched

    __________________________________________________________________________

    New Dental Leader
    Number Awarded: Up to 1
    Eligibility: Any FDA member in good standing who has been out of dental school for 10 years or less
    Nominators: Any member in good standing
    Criteria: Demonstrates outstanding leadership qualities and professional/ethical conduct; has held leadership position(s) and participated in volunteer activities in the community and/or organized dentistry

    ____________________________________________________________________________________

    Dental Student Award
    Number Awarded: Up to 1
    Eligibility: A third- or fourth-year ASDA member in good standing attending a Florida dental school
    Nominators: Any FDA member in good standing, Florida dental school faculty/staff or dental association staff (FDA or component)
    Criteria: Demonstrates exceptional leadership qualities, volunteerism, commitment, and involvement in organized dentistry

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    Leadership Award
    Number Awarded: Up to 2
    Eligibility: Council/committee/task group members, Florida Delegation members, District and Affiliate Leadership
    Nominators: Any member in good standing of an FDA leadership body
    Criteria: Length and diversity of leadership service, remarkable development and implementation of new ideas and programs, demonstrated leadership skills, successful maintenance of ongoing efforts.  NOTE: Members of the FDA Board of Trustees are not eligible to receive the leadership award.

    __________________________________________________________________________

    Dentist of the Year
    Number Awarded: Up to 1
    Eligibility: Any member in good standing
    Nominators: Any member dentist
    Criteria: Demonstrates outstanding service to the association, to the profession of dentistry, and/or to the community during the previous year as well as leadership and people-management skills

    __________________________________________________________________________

    J. Leon Schwartz Lifetime Service Award*

    *FDA's highest level award
    Number Awarded: Up to 1
    Eligibility: Any FDA member in good standing
    Nominators: District Dental Societies (through the District Executive Director - up to one nominee per district)

    Nominee must belong to the district making the nomination
    Criteria: Demonstrated dedicated effort and outstanding accomplishments in organized dentistry throughout the entire span of their career

    • 1. Choose the Award 
    • 2. Nominee Information 
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    • 3. Reason for nomination 
    • 4. Your Information 
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    • Should be Empty: