Sustainability Award - Individuals

Name

Company

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Letter of recommendation from the practice principal

One file only.
300 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

Membership to National Dental Association - enter membership number

Provide a 100 word overview of your sustainability project

What we did to improve our sustainability – not more than 300 words

Why we committed to improving sustainability in our dental clinic

What were the challenges we faced and how we overcame them – not more than 300 words

How did you engage your patients in sustainability – not more than 300 words

How could your initiative be continued or expanded in the future – not more than 300 words

Supporting photographs

Unlimited number of files can be uploaded to this field.
300 MB limit.
Allowed types: gif jpg png svg.

Supporting links or other information

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