Beulah K. Spencer Application - Electronic Form - Due March 1st 2017
THIS ENTRY IS SUBMITTED BY
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CHECK CATEGORY
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Notes: **Component or Constituent Presidents submit for Component or Constituent members. However, if the Component or Constituent President is the nominee, then the Component or Constituent President-Elect should submit the application. The Constituent President or an AADA member may submit for Members-at-Large.
SPENCER NOMINEE **
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Notes: **Candidate must have been a tripartite member or a member-at-large for ten (10) years or less. Prior Spencer recipients and student spouse members are ineligible.
NOMINEE'S CONTRIBUTIONS
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Please add a description about why the candidate should be considered for the Spencer Award, noting only significant contributions made by the candidate to her/his Alliance on the local (component), state (constituent), and/or nation level(s) in the areas of leadership, dental health education, legislative advocacy, and well-being of the dental family.
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