SAO 2022 Leadership Program Application
The purpose of this program is to provide a learning experience for individuals interested in developing leadership skills. These skills will be valuable in all kinds of leadership situations within practices, church groups, civic organizations, studyclubs and dental societies.
Cell Phone Number
Please provide us with a photo of yourself.
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1. Where do you practice (city, state-we know it might be more than one)?
2. When did you graduate your Residency?
3. What is your practice modality?
Multiple-I work in multiple offices
4. How did you hear about the SAO Leadership Program?
Word of mouth
Presentation at a state association meeting
Print or digital media
5. Can you certify that you will be able to attend all 3 sessions below? Saturday, January 15, 2022 Austin; Friday, March 12, 2022 Atlanta; Wednesday, November 2, 2022 Austin.
6. Why do you want to participate in the SAO Leadership Program?
7. Please list your current professional and civic/community involvement(e.g. AAO, dental assoc., Kiwanis).
8. What expectations would you have from the SAO Leadership Program?
9. How much time total can you allocate after the March session and prior to the November presentation of projects to the research, collection, and editing of a group project?
I'll dedicate whatever time is needed
10. Are there any particular topics for presentation by the SAO Leadership that you are most interested in hearing?
11. A portion of the programing is dedicated to a group research project. The goal/benefit is to identify opportunities the association can enhance its member benefits or areas the association should dedicate additional research/development. Recent projects have included practice opportunities, do-it-yourself orthodontics, membership target market communication. Do you have any suggestions for group research projects to be conducted by Program participants?
12. Do you prefer reading books printed or digitally?
Please mail me physical books
I prefer to download books-please send me an Amazon gift card
I’ll obtain the books myself and send in a receipt for reimbursement
13. What are you favorite hobbies and pastimes outside of work?
14. Any final thoughts you would like to convey?
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