ADAA Delegate


	Michigan Dental Assistants Association P. O. Box 118 Lennon, MI 48449

Nomination for Delegate to 2013 ADAA Annual Conference

New Orleans

Ernest N. Morial Convention Center

October 31 thru November 5, 2013

Deadline to submit this form is March 1, 2012

NOTE: Please highlight the following form, copy and paste to email

I agree that my name be submitted for election as a delegate and understand the responsibilities involved.

Delegate Application Name
Creditials
Address
City, State & Zip
Phone (home) Phone (office)
Local
Are you Certified? Yes No Certification Number
ADAA Membership Number
Email
Are you a Registered Dental Assistant? Yes No License Number Have you served as a state or local officer or been on a standing committee in the past 5 years? Yes No

Submit Copy of Form to both:

Kristi Kowalski CDA, R.D.A	Gwen Graham-Feldkamp CDA, R.D.A.
MDAA Nominating Chairperson	MDAA Secretary
795 142nd Avenue	2121 Baker Road
Dorr, MI 49323	Dexter, MI 48130

Standing Rules

Rule 8: Any member being nominated or elected as a delegate to the ADAA Annual Conference must be present in the House of Delegates at the MDAA Annual Session. Succession of Delegates involved with tie votes shall be determined by lot before the adjournment of that House of Delegates.

Rule 9: All delegates and alternates must attend all meetings scheduled to prepare for the ADAA Annual Conference or forfeit their privilege of representing MDAA, the only exception being an excused absence given by the President due to an emergency. If a delegate/alternate does not commit to attend ADAA Annual Conference at least two (2) weeks prior to the pre-registration deadline date, they will forfeit their position and be placed at the end of the list regardless of plurality vote. Resignations should be submitted in writing to the President.

Qualifications to be nominated as a delegate to the ADAA Annual Conference

All nominees must be an active, student 1, 2, 3, special or life member of ADAA and MDAA
Shall be present in the MDAA House of Delegates when nominated
Shall have served as a local or state officer or standing committee member within the last five years.
If nominee was elected and served as a delegate the previous year, they must have submitted a written report to the President within 30 days of the end of the ADAA Annual Conference.
If the nominee was elected and served as a delegate the previous year, they must have submitted receipts and written expense report to the Treasurer to verify expenses for the allotment within 30 days of the end of the ADAA Annual Conference.

Delegates elected to October 2012 ADAA Annual Conference in San Francisco

(Delegate number for will be based on December 2011 membership count)

Kelli Fedder CDA, R.D.A.	Kathy Fick CDA
Barbara Gurnee CDA, R.D.A., FADAA, BS	Jessica Seaman R.D.A.
Carol Stamm CDA, R.D.A., CCRP	Dawn Moffat CDA, R.D.A.
Deborah Spellicy CDA, BS	Paula Frolka R.D.A.
Barbara Sheldon RDH, R.D.A., MS	Monica Rethman R.D.A.
Gracie Hightower MA, R.D.A., CDA	Jennifer Kindel R.D.A., BA
Tracey McConkey CDA, R.D.A.	Kristi Kowalski R.D.A.
Deneane Paxton R.D.A.	Nellie Graves CDA, DOM, RP

Link to 2011 Las Vegas Delegate Pictures

Link to 2010 Orlando Delegate Pictures

Link to 2009 Hawaii Delegate Pictures

Link to 2008 San Antonio Delegate Pictures

Link to 2007 San Francisco Delegate Pictures

Link to 2006 Denver Delegate Pictures