Volunteer Interest Form HomeMembershipGet InvolvedVolunteer Interest Form MDA Member Dentist Volunteer Interest Form Who Are You?Name First Last Email* PhoneLocal SocietySelect OneCentralCloverlandCopper CountryDetroitGeneseeGogebic RangeJacksonKalamazoo ValleyLakeland ValleyLivingstonMacombManistee-MasonMuskegonNinthNortheasternNorthern ThumbOakland CountyResortSaginaw ValleySault Ste. MarieSouthwesternSuperiorThumbVacationlandWashtenawWest MichiganWhat Are Your Interests?What Are Your Interests?(Check all that apply.) Access to Care Charitable Care Communications Continuing Ed. Dental Benefits / Insurance Dental Practice Dental Students Ethics Finances Foundation Governance Grant Writing Health & Well-Being Insurance Products Inter-Professional Relations Leadership Development Legislation Membership Mentoring New Dentists Peer Review Prevention Public Relations Public Speaking Research / Science Social Media Special Needs Patients Study Clubs Writing Type of Involvement You Prefer?Type of Involvement You Prefer?(Check all that apply) One-Time Commitment Examples: Attend an in-district meeting with a legislator, write a Journal or newsletter article, serve as a host at a CE meeting, review a new MDA member resource, be a Mission of Mercy volunteer. Recurring Short-Term Commitment Examples: Participate in a work group or think tank, be a spokesperson for community water fluoridation in your area. Ongoing CommitmentExamples: Serve on an MDA committee, the Board of Trustees, or on a committee or board for a related organization. Where Are You Interested in Volunteering?Where Are You Interested in Volunteering?(Check all that apply) MDA Local Component MDA Foundation Michigan Donated Dental Services Michigan Mission of Mercy MDA Insurance & Financial Group MDA Dental PAC Have specific ideas on how you'd like to get involved? Tell us here!Questions?Contact Jennifer Lennemann, executive assistant, at 517-346-9461.