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Bio Data Form for Presidential Appointments

Before You Submit...

Candidates interested in applying for a position as an ADHA Presidential Appointment must submit a complete bio-data form and upload the supplemental materials listed below.

The following supplemental information is needed to upload into your bio-data form. It is a good idea to make sure have all the supplemental information available for upload before you begin your bio-data form.

1. Copy of current dental hygiene license.

2. Using the ADHA Position Description Document and Universal Skill Sets for ADHA Leadership File as a reference, produce a document of no more than 2 single sided pages describing the skills sets that you possess and your readiness and understanding of the responsibilities as a member of the board as well as the position that you seek.

3. Please provide a professional summary limited to 200 words including information on the following:
a. Education
b. Association Experience (Component, Constituent & National)
c. Professional Experience (Private Practice, Education, Managed Care)
d. Related Experience (Liaison Activities, Legislative Activities, Fundraising)
e. Professional Honors/Recognition.

You will have the option to Save & Continue your submission if you need to continue at a later time. Just look for the "Save & Continue" button at the top of the page and follow the instructions to complete it later.

Please note: if you are interested in serving on more than one committee, you must fill out a separate bio-data form for each committee you are interested in.

If you have any questions regarding the form, please contact Kathy Pujol at