Rec’d ______ Date
Distinguished Deputy Regent Evaluation Form Deputy Regent Name: District and Chapter/State: Years as Deputy Regent: The ICD USA Section Foundation created the Distinguished Deputy Regent Award to recognize and reward an outstanding individual each year for his or her service to the USA Section. The Officers and Trustees ask that you give careful attention to your evaluation of each candidate and be as objective as possible. The evaluation will be based on a scale of 1 to 10, with 10 being exceptional or excellent performance. Please enter your score for each category and add your total at completion of the evaluation. Please return form and typed narrative by Wednesday, April 1, 2020. These forms will become the property of the Foundation and will be kept in their confidential files.
Score 1. Timely appointment of Counselor(s) and Editor with Regent approval and Section Office notification. 2. Timely processing of sponsors’ candidate information forms approved by the Screening Committee. 3. Ensures Candidate Information Form is in order for submission to Regent. 4. Ensures the state membership is of equitable distribution of good members with regard to age, locale, etc. 5. Good communication with Regent and Constituency/Chapter. 6. Forwards to the Section Office and Regent immediate information on the death of a Fellow. 7. Timely investigation upon request of resignations, retirements, delinquency of payments and other important matters of the Section Office. 8. Timely submission of reports to the Regent concerning activities of importance as prescribed by the Regent. 9. Conducts an annual meeting of the Constituency/Chapter with appropriate programming acceptable to the membership. 10. Development of projects and reorganization of programs to maintain interest. 11. Attends Deputy Regents Brunch at annual meeting and other important district meetings. 12. Creative and enthusiastic leader. (Give narrative evaluation on separate page.) Total: Regent: District: Signature: ________________________________________ Return by: Wednesday, April 1, 2020 Mail to:
International College of Dentists USA Section Foundation 610 Professional Drive, Suite 201 Gaithersburg, MD 20879
OR E-mail to: kylie@usa-icd.org Fax to: (240) 224-7359
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