BETA TEST–Nomination Forms

Nominations are accepted year-round, and our Fellows are encouraged to submit quality candidates as they identify them. 

Deadlines for Specific Convocation Years

ACD 2019 – San Francisco, September 5-6 – December 31, 2018

ACD 2020 – Orlando, October 14-15 – January 15, 2020

Most successful nominations include a thorough description of the nominee’s commitment to leadership within dentistry and in service to the wider community. For dentists in the earlier years of their career, it is advisable for the nominator to focus on the leadership trajectory and potential of the nominee.

By submitting either or both of these forms you attest that you are a Fellow in good standing of the College and that you have abided by the ACD bylaws which state that all nominations are made confidentially and the nominees have not been made aware of their nomination.

Please do not hesitate to contact the office with any questions you might have about the nomination process or timeline.

Contact the Office

Please note that if you save the web form to finish later you will have 30 days to complete and submit the form.

Please note that if you save the web form to finish later you will have 30 days to complete and submit the form.

Nomination for Fellowship

Fields with an asterisk (*) are required.
  • Nominations are accepted year-round, and our Fellows are encouraged to submit quality candidates as they identify them. Cut-off dates for Specific Convocation Years: ACD 2019 – San Francisco, September 5-6 – December 31, 2018 ACD 2020 – Orlando, October 14-15 – January 15, 2020. Successful nominations include a thorough description of the nominee’s commitment to leadership within dentistry and in service to the wider community. For dentists in the earlier years of their career, it is advisable for the nominator to focus on the leadership trajectory and potential of the nominee. By submitting the Profile Summary and/or the Nomination Form you attest that you and the Seconder are Fellows in good standing of the College and that you have abided by the ACD bylaws which state that all nominations are made confidentially and the nominee has not been made aware of their nomination. Please do not hesitate to contact the office with any questions you might have about the nomination process or timeline.
  • Support Statements

    Please respond to the request for supporting information below, focusing on the value and significance of the accomplishments listed on the Profile Summary. Please do not duplicate the list from the Profile Summary. For dentists who are in the earlier phase of their careers, please emphasize their potential and trajectory as demonstrated post-dental school.
  • Please describe the value of the nominee's leadership experience.
  • Please describe the level of commitment and the value of the nominee's service to others, whether in dentistry or in their community.
  • Please describe the significance of the nominees's publications and recognitions.
  • Please include any other relevant information about the nominee.
  • By submitting this nomination, both the Nominator and the Seconder affirm that the Support Statements are their own work, and that the Nominee has not been made aware of his or her nomination, as required in the ACD Bylaws.
  • If you choose the Save and Continue Later option, please reopen the Online Nomination Form tab to obtain the link for future use.