CDA Foundation Humanitarian Award

Unselfishly volunteering time, resources, and professional skills is a commendable act that bridges the lack of care for underserved populations and makes a difference in other’s lives. The mission of the CDA Foundation Humanitarian Award is to support California dentists who have distinguished themselves by outstanding, unselfish leadership and contributions to fellow human beings in the field of dentistry.

Thank you for expressing interest in the CDA Foundation and its award program. We appreciate you nominating an individual for our award which is available to benefit people who want to improve the oral health of others.

Prior to beginning the online nomination process, please scan and save the following supporting documents (PDF file type is preferred), which you will need and attach to this nomination later:

A Curriculum Vitae/resume (maximum 3 pages) highlighting the nominee’s humanitarian contributions;
Two letters of support (maximum 2 pages) from individuals other than the nominator; and
Letter of support (maximum 1 page) from a recipient of the nominee's efforts.
Optional, other supporting documentation (maximum 3 pages) to substantiate and fully present the character and achievement of the nominee at the discretion of the nominator (testimonials, narrative, photographs, brochures, news articles, etc.).

During this nomination process you will need to answer the questions by typing text, checking boxes/buttons, and where prompted, upload/download documents as attachments. All requested file uploads and downloads are required to complete your nomination. Once we have received your nomination packet, an automated confirmation will be sent to you (nominator) at the e-mail address provided. Thank you for nominating a deserving humanitarian!

Submission Criteria

Nominator must be a CDA member or a component dental society executive director.
Nominator is limited to one nomination per award cycle.
Complete online nomination form, attaching all supporting documents, and submit online.
No mailed, e-mailed or faxed nomination packets will be accepted unless approved by the CDA Foundation. If you are experiencing difficulties submitting the online application, please contact the CDA Foundation staff via e-mail at jolene.murray@cda.org to request an alternative submission method and a Word document of the award nomination packet will be sent to you for completion.

Incomplete nomination packets are ineligible to receive an award.

Light Purple Shaded Areas are Required Fields

I. Nominator Information

Nominator's Name First Name Last Name

Please provide your CDA membership number or component dental society that you hold executive directorship at

Address Street Street (cont.) City State Zip

Phone Number E-mail Address

II. Nominee Information

I, hereby, nominate for the CDA Foundation Humanitarian Award:

Nominee's Name First Name Last Name

Nominee's Home Address Street Street (cont.) City State Zip

Nominee's Home Phone Number Nominee's E-mail Address

III. General Information

Tell us how you (nominator) are directly involved in the activities of the nominee:

Organization Staff Volunteer Service recipient Other Not directly involved

How did you become acquainted with the nominee's service?

Maximum 650 characters. Characters used: 0.

A humanitarian is generally defined as a person actively engaged in promoting human welfare and social reforms, as a philanthropist; a person who professes ethical or theological humanitarianism.

IV. Nominee's Background of Humanitarian Efforts

Describe the period of time the nominee conducted humanitarian activities.

Maximum 1,000 characters. Characters used: 0.

Describe the undertakings, programs, or activities that the nominee contributed to improving the quality of life and oral health.