CALL FOR NOMINATIONSThe due date for 2019 Gies Awards nominations is Thursday, Sept. 13

LEADERSHIP INNOVATION LEGACY

CALL FOR NOMINATIONSThe due date for 2019 Gies Awards nominations is Thursday, Sept. 13

LEADERSHIP INNOVATION LEGACY

ADEAGIESFOUNDATION.ORG#GIESAWARDS

ADEAGIESFOUNDATION.ORG#GIESAWARDS

ADEAGIESFOUNDATION.ORG#GIESAWARDS

introductionThe 12th Annual William J. Gies Awards for Vision, Innovation and Achievement

The ADEAGies Foundation® is accepting nominations for the 2019 Gies Awards for Vision, Innovation and Achievement. You are invited to nominate individuals and organizations that exemplify the highest standards of vision, innovation and achievement in oral health and dental education. The deadline is Thursday, Sept. 13.

Named after dental education pioneer William J. Gies, Ph.D., the Gies Awards recognizes the work of modern-day trailblazers who are leading academic dentistry forward. These visionary leaders and innovators are actively identifying solutions that address the complex challenges impacting the dental profession.

The 2019 Gies Awards take place Monday, March 18, in conjunction with the 2019 ADEA Annual Session & Exhibition in Chicago.

Join us to honor the legacy of Dr. Gies, promote the work of future-ready leaders and celebrate the innovation and achievement of visionaries in our community.

Leo E. Rouse, D.D.S., FACD Chair, ADEAGies Foundation Board of Trustees

award categoriesPlease review all award categories carefully to help us celebrate those most deserving in our community.

ELIGIBILITY AND TYPES OF ENTRY

Vision Programs, institutions and educators articulating the pursuit of contemporary ideas or a set of ideals, perspectives or solutions to create broader meaning for the dental profession and effectively bridge the present to the future of oral health.

Innovation Programs, institutions and educators facilitating the creation, exchange, evolution and application of ideas that bring new value to our profession or industry and enhance oral health through dental education.

Achievement Programs, institutions and educators achieving socially commendable actions that make a substantial contribution to oral health and dental education.

Academic Dental Institution An educational institution granting academic degrees or certification in predoctoral, allied or advanced dental education.

Dental Educator An instructor or administrator in any predoctoral, allied or advanced dental education program.

Public or Private Partner An individual, corporate, nonprofit or governmental entity with a dental, educational, public service or consumer mission working toward common goals in oral health or dental education.

ADEAGIESFOUNDATION.ORG#GIESAWARDS

nomination packagesAll nomination packages must include:

• The completed entry form on the following page.

• Identification of the category and classification for which an individual or organization is being nominated. (Choose only one category per nomination.)

• The nominee’s full name, including designations and classifications.

• Contact information for the award nominee and submitting body. (Please include both parties’ business address, telephone number and email.)

• An executive summary outlining the nominee’s contributions to and support of oral health and dental education, corresponding with the definitions previously provided in the “Categories” section for Vision, Innovation or Achievement. (The executive summary may be up to two pages.)

• A letter of nomination, explaining why you are nominating the person or organization and what distinguishes that nominee as a potential Gies Award winner (up to one page). Only individuals in charge of submissions may provide a letter of nomination; no other recommendation letters should be included.

• Any supplemental materials documenting the nominee’s program or service, including samples, planning documents, videos, DVDs, marketing or promotional materials.

selection processIf no nominee meets the eligibility requirements or standards for an award, the award may not be given. Each finalist selected may be asked to provide additional information and must be willing to accept the award in person at the 2019 Gies Awards gala.

KEY DATESCALL FOR NOMINATIONS CLOSESThursday, September 13

GIES AWARDS WINNERS ANNOUNCEDWednesday, October 17

entry form

Complete all the information below. Nominations must be received by Sept. 13. (Late submissions may be considered solely at the discretion of the 2019 judging panel.)

Nominee’s Name or Company ________________________________________________________________________

Institution/Company/Contact Name ___________________________________________________________________

Address ____________________________________________________________________________________________

City _______________________________ State or Province _______________ ZIP Code _______________________

Telephone __________________________________ Email _________________________________________________

For Individual Awards: Submission Point of Contact ______________________________________________________

For Group Awards: Submitter Institution/Company ______________________________________________________

Address ____________________________________________________________________________________________

City _______________________________ State or Province) _______________ ZIP Code _______________________

Telephone __________________________________ Email _________________________________________________

I, _______________________________, confirm that the nominee, if selected as an awardee, may participate in the award presentation on the evening of Monday, March 18, 2019.

I, _______________________________, agree that the nominee information provided herein is, to the best of my knowledge, current and accurate, and that the nominee has given me permission to provide this information and supporting collateral to the ADEAGies Foundation for its use.

I, _______________________________, hereby grant permission to the ADEAGies Foundation to use this entry as part of a webcast, DVD or Video on Demand distribution, and for future ADEAGies Foundation promotional purposes. I also certify that I have the right to grant this release or have secured the rights necessary for this purpose.

CATEGORIES AND TYPES OF ENTRY

Each submission requires a separate entry form; duplicate this form to submit multiple entries.

SELECT ONLY ONE OF THE FOLLOWING PER ENTRY:

{ Gies Award for Vision: Academic Dental Institution { Gies Award for Vision: Dental Educator { Gies Award for Vision: Public or Private Partner { Gies Award for Innovation: Academic

Dental Institution { Gies Award for Innovation: Dental Educator

{ Gies Award for Innovation: Public or Private Partner

{ Gies Award for Achievement: Academic Dental Institution

{ Gies Award for Achievement: Dental Educator { Gies Award for Achievement:

Public or Private Partner

Executive Summary: Attach the executive summary (up to two pages) demonstrating the nominee’s exceptional contribution to, and support of, oral health and dental education through Vision, Innovation and Achievement, as defined by this Call for Nominations. One letter of nomination should be submitted.

Supporting documents: Attach existing material documenting the nominee, program or service, including samples and planning documents, videos, DVDs, marketing or promotional materials.

Return this nomination form to:The Gies Awards c/o MCI USA/Attn: Amy Lotz, 7918 Jones Branch Drive, Suite 300, McLean, VA 22102

Nominations may also be sent via email to amy.lotz@mci-group.com.