2025 Fellowship Award Convocation Reply Form

Please complete this form by Friday May 9, 2025. Email education@agd.org if you have any questions.

Convocation attendance is mandatory for Fellowship Awardees.
Approved 2025 Fellowship Award candidates have three opportunities to attend a Convocation Ceremony (AGD2025, AGD2026, or AGD2027)

AGD Member ID

First Name

Constituent Name

Middle Initial

Last Name

Select preferred option

I WILL attend Convocation Ceremony Saturday, July 12, 2025 in Montréal, QC

I WILL NOT attend Convocation Ceremony Saturday, July12, 2025 in Montréal, QC

Please confirm how you would like your name to appear on your Fellowship Award Plaque:

Please confirm your mailing address to receive your Fellowship Award Plaque. Please note Fellowship Award Plaques will not be delivered to P.O. Box addresses.

Name

Address

City

State/Providence

Zip Code

If you and your spouse or other family member are receiving the 2025 Fellowship Award please provide their name here so we can seat you together:

If you and your spouse or other family member are receiving a different award or recognition please provide their name here:

Family members receiving different awards/recognitions cannot be seated together, but AGD staff will provide direction so you can have your photos taken together on-stage with the AGD president.

Sponsored by AGD Corporate Sponsors:

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