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UMMC Alumni Affairs

2010 Dental Alumnus/Friend of the Year Nomination


The University of Mississippi Dental Alumnus/Friend of the Year Award was created to honor a person who has made an outstanding contribution to The University of Mississippi School of Dentistry and the Dental Alumni Chapter. The Alumnus/Friend of the Year is one who enhances the image of The University of Mississippi School of Dentistry as well as the dental profession through various activities. These activities include community service, legislative activities, participation in organizations affecting dental practice, and/or contributions to education and research. The honoree is also an active member of the Dental Alumni Chapter.

All dental alumni and friends are eligible for consideration. From the nominations submitted, one will be chosen by a committee and will be honored at the Annual Alumni & Friends Dinner to be held Friday, April 16, 2010.

If you know someone who should be considered for the 2010 Alumnus/Friend of the Year Award, please complete the form below. You may submit additional biographical information in support of your nomination to (groby@alumni.umsmed.edu) or fax it to (601)-984-1740.

It is essential that the person submitting the nominations send all materials pertinent to the nominee. The committee will do no further research. Nominations must be received by February 19, 2010. For additional information, contact the Office of Alumni Affairs at (601) 984-1115 or 1-800-844-5800.



Nominee:

Address: City: State:

Email Address: Phone:

Dental School: Class of:

Field of Achievement:

Description of Accomplishments:


(Please send curriculum vitae and any other supporting documents in a separate email)

Local/State/National Societies:

Honors, Awards, and Recognition:

Community Involvement:

Submitted By:

Email Address: Phone: