Dental Student Award
The American Academy of Oral and Maxillofacial Radiology is requesting nominations for Radiology Achievement Awards again this year. The nominee should be a senior student at yourdental school who has demonstrated special interest and accomplishment in Oral and Maxillofacial Radiology. They will be presented with a certificate.
Name of Student as it will appear on the Certificate
First Name
Last Name
Date of Award Ceremony
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Month
-
Day
Year
Date
Institution
Name of Contact Person to Send the Certificate to
First Name
Last Name
Email of Contact Person to Send the Certificate to
example@example.com
Submit
Should be Empty: