Alumni Awards Nomination

The MUSC James B. Edwards College of Dental Medicine Alumni Association is accepting nominations for the 2021 Alumni Awards. Please use this form to nominate a degree or residency alumnus/alumna of the James B. Edwards College of Dental Medicine or an individual who has made significant contributions to the profession of dentistry, their community, and/or the college for recognition through one of the association’s awards.

Nominations received after the closing date of Feb. 19, 2021, will be considered for the 2022 Alumni Awards. Those received with incomplete information cannot be considered.

Nomination Form

Your Contact Information

You may be contacted directly by an alumni staff member for additional information on the nominee.

Your Full Name

Your Email

Your Phone

Relationship to Nominee

Nominee's Contact Information

First Name

Nickname

Middle/Maiden Name

Last Name

Street Address

City

State

Zip

Daytime Phone

Evening Phone

Email Address

Nominee's Education & Professional Information

College(s) attended (undergraduate, master’s, doctorate), class year(s), degree(s) earned

Award Category (select one)

Alumni Award of HonorThe Alumni Award of Honor is the highest honor bestowed by the College of Dental Medicine Alumni Association. This award is presented to a degree or residency alumnus/alumna of the College of Dental Medicine in recognition of outstanding service and contributions to the alumni association, the college, their community, or the profession of dentistry. The dental community holds the recipient in the highest esteem.

Distinguished Alumnus/Alumna Service AwardThis award is presented to a degree or residency alumnus/alumna of the College of Dental Medicine who as given selflessly through extraordinary activities that benefit the college, their community, or the profession of dentistry during the past year.

Honorary Alumnus/Alumna AwardThe Honorary Alumnus/Alumna Award is presented to an individual who has made outstanding contributions to the college or the profession of dentistry but is not an alumnus/alumna of the college. Honorary alumni members shall enjoy any rights and privileges of the alumni association.

Young Alumnus/Alumna AwardThe Young Alumnus/Alumna Award is presented to a degree or residency alumnus/alumna of the College of Dental Medicine who has shown exemplary leadership and dedication towards the Medical University's College of Dental Medicine and organized dentistry as a whole.

Nomination Statement

Please provide a brief statement on why you have nominated this individual for the CHP Alumni Association’s Award

Upload Curriculum Vitae

Please do not include any personal identification numbers such as social security or license numbers. You may send the CV at a later date to alumni@musc.edu or fax to 843-792-7787