Champion for Oral Health Award Nominations Year of nomination(Required)20242025202620272028202920302031203220332034Is this nominee an individual or an organization?(Required) Individual Organization Nominee InformationFull name of nominee(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Suffix Job title (if applicable)Employer/organization (if applicable)Nominee Email(Required) Nominee Phone(Required)Organization Name(Required)Headquarters are located in:(Required)Contact Name(Required) First Last Contact Title(Required)Contact Email(Required) Contact Phone(Required)Does this person/organization know that they have been nominated?(Required) Yes No Nominator InformationFull Name of Nominator(Required) First Last Email(Required) Phone(Required)Based on the criteria, in under 500 words, explain why this individual or organization should be recognized with the IOHA Champion for Oral Health Award.(Required) Δ
