ADAAF Forms

This award comes from the Kay Mosley Fund and was created in honor of ADAA’s Past President Kay Mosley, CDA, of Oklahoma City, Okla. Ms. Mosley was President of the ADAA in 2003-04 and continues to be active in state and local dental assisting affairs and with the ADAA Foundation.

The Mosley Fund has been incorporated into the Foundation and the award specifically recognizes significant contributions to the ADAA and to the Foundation itself and to the field of dental assisting and dentistry. These contributions shall have been demonstrated through leadership, personal accomplishment and vision for the profession of dental assisting.

A $2,500 honorarium is presented with this award along with commemorative materials. Fee for gala tickets for recipient and a guest shall be waived.

Qualifications
The award is funded by the Kay Mosley Fund and the recipient is selected by the ADAA, ADAAF and a representative of the Fund. It does not carry a mandate for annual presentation.
1.   The recipient must be a current member of ADAA.
2.   Recipient must attend the Annual Conference to receive the award (unless the winner is on active military duty).
3.   No ADAA board member, officer, trustee or staff member may be considered.
4.   No one may receive the award more than once.
5.   Shall have made significant contributions to the ADAA and ADAAF and the profession of dentistry in general.

Procedure
Any member of the ADAA or the ADAA Foundation may nominate another using this ADAAF Award Nomination Form and submitting it by June 30 to the Awards Chair at Central Office. A letter of recommendation is suggested.

ADAA Foundation-Kay Mosley Distinguished Service Award

ADAAF Nomination Form

ADAAF Volunteer Agreement Form

(Please download both the Nomination & Volunteer Agreement forms and return by their deadline dates.  Thank you!)