PDF format - the California Dietetic Association!
PDF format - the California Dietetic Association!
PDF format - the California Dietetic Association!
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Submitted by: The <strong>California</strong> <strong>Dietetic</strong> <strong>Association</strong><br />
AND OUTSTANDING DIETETICS STUDENT AWARDS<br />
DATA SHEET SELECTION FOR 2014<br />
Complete and email to cdaawards@dietitian.org<br />
Submit name as you would like it to appear on a certificate should you be selected<br />
Submit three letters of recommendations<br />
Submit a picture (headshot) of nominee.<br />
Student Name: First Name Middle Initial Last Name Credentials<br />
Home Street Address<br />
City, Zip<br />
AND MEMBER # Day Time Phone Number Email Address<br />
STUDENT’S CURRENT EDUCATIONAL PROGRAM(Please check one)<br />
Coordinated<br />
Program<br />
<strong>Dietetic</strong><br />
Internship<br />
Didactic Program<br />
in <strong>Dietetic</strong>s<br />
<strong>Dietetic</strong><br />
Technician<br />
Institution City State<br />
ACTIVITIES AND HONORS.<br />
Date<br />
Briefly list student’s achievements including: honors (academic and o<strong>the</strong>r), student dietetic<br />
association activities, community service activities, etc.<br />
Application Coordinator:<br />
District or Committee:<br />
<strong>California</strong> <strong>Dietetic</strong> <strong>Association</strong> Contact:<br />
CDA CENTRAL OFFICE – 310/822-0177 cdaawards@dietitian.org<br />
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