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Bio Data Form for Volunteer Positions

Before You Submit...

Candidates interested in applying for a position as a volunteer for ADHA must complete the following bio-data form and upload the required supplemental materials. It is a good idea to make sure have all the supplemental materials available for upload before you begin your bio-data form. The following supplemental materials are required in the form:

1. Copy of current dental hygiene license.

2. Using the 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. In no more than three pages, please upload a brief resume which includes the following information in this order:
a. Education
b. Association Experience (Component, Constituent & National)
c. Professional Experience (Private Practice, Education, Managed Care)
d. Related Experience (Educators should include any experience with curriculum design, development, and evaluation; and/or have responsibility for a dental hygiene program; accreditation experience through an affiliation with a dental hygiene education program that has completed a site visit)
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 at a later date.

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

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