Yes, I would like to be considered for the MDS Leadership Institute. The deadline for submitting an application is May 31, 2015. A limited number of positions are available each year. Applications are reviewed and final selections are made by the MDS Membership Committee.
This application is also available to download as a PDF form.
What do you hope to achieve from the MDS Leadership Institute Program?
What prior volunteer roles/activities have you been involved with? (Please list dental and community.)
Submit CV: Please submit your CV by email (email@example.com), fax (508-480-0002) or mail (Two Willow Street, Suite 200, Southborough, MA 01745)
I understand that I am agreeing to attend:
Four half-day Wednesday Meetings will be held at the MDS Headquarters in Southborough.
|September 16, 2015
|October 21, 2015
|February 10, 2016
| March 9, 2016
Special Team-building Evening Program (location TBD)
|November 18, 2015
Upon completion of the first year, participants will be required to serve on a special Ad Hoc Committee. You will have the opportunity to decide on the committee’s focus and its effects on the profession. There will be a kick-off meeting held at the MDS Headquarters in Southborough.