February 26 - 27, 2026 at the Hotel Northland, Green Bay, Wisc.

Deadline for submitting applications is Friday, August 8, 2025. Contact WDA Director of Membership and Communications Brenna Sadler at bsadler@wda.org with questions.

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* 1. Contact Information

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* 3. Past & Current Involvement with Organized Dentistry (e.g., projects/events; committees; local leadership; state level committees;  WDA House of Delegates)

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* 4. Past & Current Leadership Positions with Other Organizations

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* 5. Interest in Serving as Future Local Dental Society and/or WDA Leader

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* 6. Miscellaneous Comments