Volunteer Nomination Form

The DC Dental Society strives for diversity with respect to its volunteer leadership and specifically encourages new dentists to nominate others or self-nominate.

Instructions: Complete all required fields and click on the submit button at the end of this form to complete your nomination application.

Nominee Information:

Nominee First Name

Nominee Last Name

I identify myself as a new dentist (out of school less than ten years)

Yes
No

Gender

Male
Female

Nominations

Please check the position(s) for which you are interested in being considered.

Committee Positions

Volunteers are selected by Awards & Nominating Committee recommendation and vote by the Board. (Selected candidates will begin their terms at the conclusion of the June 2019 Awards Dinner.)

Select choices

Awards & Nominating Committee
Constitution and Bylaws Committee
Education Committee
Finance and Advisory Committee
Membership Committee
Membership Benefits Committee
New Dentist Subcommittee
Professional Standards Committee
Public Policy Committee
Public Relations Committee
Spring Meeting Committee

Volunteer Activities

Please list DCDS volunteer activities in which you have been involved and the year(s) of the activities. Activities include service on the DCDS board or a committee, participation in DCDS public outreach events like the DC Give Kids a Smile Day, NBC4 Health & Wellness Expo, etc.

Volunteer Nomination Form

Nominee Information:

Nominations

Committee Positions

Volunteer Activities

Stay Connected

General Information

Sections

Resources