William J. Gies Foundation Award in Oral and Maxillofacial Surgery Nomination Form

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Nominee Information

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List your nominee's professional credentials:

Include a current curriculum vitae with bibliography:*

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Nominator Information

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Essay

Describe and enumerate how the nominee’s work has significantly contributed to the education of the public about the dental specialty of oral and maxillofacial surgery, and the positive impact on the public health and welfare resulting from the surgical procedures provided by dedicated oral and maxillofacial surgeons throughout the United States. Present succinctly why your nominee is recommended for this award.

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Nominee Information

Nominator Information

Essay

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