Physician Citizenship Event

In partnership between Kent County Medical Society, Kent County Osteopathic Association, Ottawa County Medical Society, and Boy Scouts of America, a group of volunteers have developed a unique opportunity for physicians to gather and celebrate their peers. This annual event will include networking opportunities, recognition of a physician from the community, and support of the Boy Scouts of America. On October 7th, 2019 at 6:00pm, hors d’oeuvres and drinks will be served at the brand new Adventure Point, 3213 Walker Ave NW, Grand Rapids, MI, 49544.

The Physician Citizenship Award has been designed to recognize exceptional service to our community by a physician within Kent or Ottawa County. The form can be found online at:

https://www.cognitoforms.com/MichiganCrossroadCouncil/_2019PhysicianCitizenshipAwardNomination

Nominations are due by September 10th.

The information below is included for your convenience. 

To be considered for the Award, candidates must meet the following criteria:

1. Currently practice within Kent or Ottawa County.
2. Possess the following qualities and experiences:
   • Have demonstrated exceptional and measurable contributions and service within the community.
   • Demonstrates a commitment of excellence in their practice
   • Demonstrates professionalism in all interactions and in all forums.

Please fill in the information of the person you are nominating for the Physician Citizenship Award below.

• Name of Nominee
• Nominee Professional Title
• Nominee Company Name
• Name of Nominee Spouse
• Address of Nominee
• Nominee Home & Mobile Phone
• Nominee Email

Please fill out the contact information for the person submitting the nomination

• Name
• Address
• Phone
• Email

Please answer the following questions about the Nominee.

• Describe the significant citizenship to the community that this nominee has contributed.
• Please list other community recognitions or achievements (Name/Type, Year, Descriptions)
• Please list other community organizations affiliations or citizenship activities (Organization/ Name, Position/ Responsibility, year/term)
• Please share below any noteworthy comments on service of character to youth and/or our community