FDA Trustee Application

Please list your qualifications for this position. (Leadership roles, experience, etc.)*
Please list any boards, committees or other groups you currently or previously have served on (dental or non-dental) along with years of service.
Please share any accomplishments while serving in other leadership positions.
Have you participated in continuing education or training programs in leadership? If yes, please share your experience.*
Do you think there is value in the tripartite membership structure (ADA/FDA/Component)? Why or why not?*

0/250
The mission of the FDA is to "Help Members Succeed". Do you feel that the association is fully utilizing its resources to fulfill this mission? If yes, share why. If no, what additional actions would you propose?*

0/500
What are the biggest challenges you see for the FDA as an organization in the coming years and what are ways you suggest the FDA can meet those challenges?*

0/500

Technology Expectations

Board communications and Board meeting materials are provided electronically. We want to assess your current level of technological capabilities so that training can be scheduled if necessary. Please use the checkboxes below to select your current level of technology.
Do you currently have: (check all that apply)*

Access to high-speed internet capability.Access to email correspondence and response on a timely basis.Ownership or willingness to purchase a laptop computer or tablet.Access to a current version of Adobe Reader.Ability to open and use Microsoft Teams.
*FDA staff can work with you to get you up to speed on technology needs if necessary. Are you amenable to training?*

YesNo
Please provide any additional information you would like to share.

0/175
If a special election is needed due to a vacancy in an at-large trustee position, I would like to run for that position.*

YesNo
Should be Empty: