Awards

Trailblazer Award Nomination Form

The NMDHA’s Trailblazer Award recognizes outstanding achievement and dedication to the profession of dental hygiene in New Mexico within five (5) years of graduation.

All application materials must be emailed by the deadline. Additional attachments may be used. The award may not be given on an annual basis.

NOTE

This application will be evaluated by the NMDHA Awards Council. Each application is blinded and scored by a panel of three (3) judges. The application will be evaluated based on the responses in each of the following sections:

• Section I Leadership Experience
• Section II Community Service Activities
• Section III Association Activities
• Section IV Essay

Each section will be evaluated independently to achieve a total composite value for each nominee evaluation. The total composite score from all council members will determine the recipients of the award.

Please allow ample time for completing the application and provide detailed information for each section.

Nominee should be able to be present for awards ceremony at NMDHA Annual Scientific Session, held in the fall. Look at nmdha.org for the exact date closer to the NMDHA Scientific Session.

Nominee Information
ADHA Member ID#
Year of Dental Hygiene Graduation *
Name *
Address 1
Address 2
City
State
Zip Code
Best Phone Number
Email
Section I Leadership Experience Do not refer to your nominee by name. All applications are scored blindly by the awards council. The Nominee or Nominator can complete this application.
SADHA National Officer/Council Experience:
SADHA Officer Positions held: Year(s):
SADHA Council Positions held: Year(s):
NMDHA Component Experience:
Component Officer Positions held: Year(s):
Componenent Council Positions held: Year(s):
NMDHA National Officer/Council Experience: (Include ADHA Delegate/District Trustee Experience)
NMDHA Officer Positions held: Year(s):
NMDHA Council Positions held: Year(s):
Section II Community Service
Do not refer to the nominee by name. All applications are scored blindly by the awards committee. The Nominee of Nominator can complete this application. Discuss community service activities related to dental hygiene in which your nominee has been an active participant. Include the level of involvement and outcome, if applicable.
Section III Association Activities
Do not refer to the nominee by name. All applications are scored blindly by the awards committee. The Nominee of Nominator can complete this application. Describe how your nominee has contributed to the advancement of the association other than offices held, council positions, or council work. Include detailed descriptions on specific activities including level of involvement, time commitment, and outcomes.
Section IV Essay
Describe your commitment and dedication within the past five years to the New Mexico Dental Hygienists’ Association.