The Colgate-Palmolive / Hispanic Dental Association Faculty Recognition Award recognizes faculty who are members of the
Hispanic Dental Association and who have made a contribution toward enhancing the overall quality of oral health for the
Hispanic population by extending themselves beyond the scope of their position. Three awards are available, and recipients are selected by a review panel comprised of members of the HDA Awards Committee.
Award Recipients will receive the following:
 Recognition and award plaque at the 2012 HDA Annual
 A cash award of $500.00.
 Travel or meeting registration assistance funds in the amount of $200.00.
 A complimentary HDA professional membership for the 2013 member year.
CRITERIA FOR SELECTION:
 Must be a current HDA member.
 Must be a faculty member at an accredited U.S. Dental School (including Puerto Rico).
 Must demonstrate exemplary values, dedication, and a willingness to assist beyond the requirements of their position in one or more of the following activities:
 TEACHING
Effective teaching methods
Personal interaction and mentoring of students
Support others in their quest for knowledge and advancement of research/clinical experiences that will expose them to current techniques in surveillance and interventions directed at improving the health of the Hispanic population.
 RESEARCH
Ongoing research
Publications
Promotion of research for students and colleagues
Presentation at scientific / professional meetings
 SERVICE / ADMINISTRATION
Advocate for students, influence school policies
Serve on academic / professional committees
Participate in and/or sponsor activities of the local (if existing) HDA student chapter
Community activities / service
REQUIREMENT GUIDELINES:
1.
Nominations may be made by Deans or Faculty at an accredited U.S. Dental School (including Puerto Rico). Self nomination is not accepted.
2.
Complete the Nomination Form on page two.
3.
Submit a Letter of Nomination to the HDA Awards Committee. Letter of Nomination MUST address which award criteria listed above is specific to this nominee. Indicate in the Letter a detailed description of how the nominee meets the award criteria. Give examples of specific activities that have been accomplished and/or participated in by nominee.
4.
Submit CV (curriculum vitae) of faculty member being nominated.
5.
Email (no snail mail please) completed form, Letter of Nomination, and CV to Christina Gordon at cgordon@associationcentral.org
and return no later than DEADLINE: Friday, June 15, 2012 .
6.
Late submission will NOT be accepted.
Questions? Contact Christina Gordon at the HDA National Office by email cgordon@associationcentral.org
or phone 800-852-
7921.

Faculty Full Name
Credentials
Title
University
Department
Address
Address
City / State / Zip
Email Address
Work Phone
Cell or Home Phone
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