VETERANS:

Whether you served as a dental officer, infantryman, fighter pilot, or supply clerk, we would like to recognize your military service. Please complete our online nomination form and submit it to FWDDS before October 31, 2019. The FWDDS Board of Directors will select a veteran from the nominations to be honored at our November monthly meeting. The nominee must be a current member of the FWDDS to be eligible for this award.

If you know of a member dentist who served in the Armed Forces, please nominate him or her to be honored.

First Name:

M.I.

Last Name:

Period of Military Service:

World War II, Korea, Vietnam, Desert Storm, etc.

Date/Years of Service:

When did you serve?

Highest Rank Earned & Branch:

What was your rank and what branch(es) of the military did you serve?

Awards & Accomplishments:

Please provide a list of awards and accomplishments during your service.

Please give a brief synopsis of your military experiences including campaigns participated in, duty stations, qualifications earned (such as pilot or parachutist), clinical duties as a dental office (if applicable) and continuing education earned.

Military Experience:

(Qualifications earned from above)

Email Address:

Telephone Number:

Date:

VETERANS:

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