Alumni Award Nomination Information and Form

Eligibility

Boston University Henry M. Goldman School of Dental Medicine Alumni Award

In order to be nominated for this award, an individual:

Should be a graduate of the Boston University Henry M. Goldman School of Dental Medicine.
Should serve as an ethical and professional role model dentist.
May not be a sitting member of the Boston University Henry M. Goldman School of Dental Medicine Alumni Board.

Nomination Process

All Boston University Henry M. Goldman School of Dental Medicine Alumni are invited to nominate an individual whom they believe to be the most deserving recipient of the Alumni Award.

Completed nomination forms, along with a copy of the nominee’s curriculum vitae (CV), must be received by Ms. Stacey McNamee Director of Alumni Relations by June 15.

Selection Process

The entire Boston University Henry M. Goldman School of Dental Medicine Alumni Board will act as the Screening Committee for all nominees. Ms. McNamee will forward copies of each nomination form to every member of the Screening Committee as soon as possible after the nomination deadline.

Each committee member will independently evaluate the nominations and select the individual that he or she feels to be the most deserving.

Typically, only one Alumnus is granted annually. However, if the caliber of nominees is particularly outstanding, two awards may be granted.

In the event that the nominees do not meet the above criteria, the Alumni Committee may not recommend an award.

Recipient Obligations

Recipient must be present at alumni reception during alumni weekend to accept the award.

Alumni Award Nomination Form

Nominator name(Required)

First Last

Contact address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

The below individual is being nominated to receive Boston University Henry M. Goldman School of Dental Medicine Alumni Award

Nominee name(Required)

First Last

Nominator signature(Required)

Type Your Name to Sign

Date(Required)

When answering the questions below, please be brief and to the point.

Describe the nominee’s contributions to the profession.(Required)

Describe the nominee’s activities that exemplify his or her commitment to the profession of dentistry.(Required)

Describe how the nominee has served as an ethical and professional role model.(Required)

Provide any additional reasons why this nominee should be selected to receive the Boston University Henry M. Goldman School of Dental Medicine Alumni Award.