Please list and community activities in which the candidate has been involved (if applicable): Submitted by: Name: Title: District: Date: Please date this form and type the name of the District President or Trustee prior to submitting it to the MDA. A curriculum vitae and other information may accompany this form. Please mail nomination materials to the Minnesota Dental Association, 1335 Industrial Blvd, Ste 200, Minneapolis, MN 55413, fax to (612) 767-8500, or email: . you.
Please list and community activities in which the candidate has been involved (if applicable): Submitted by: Name: Title: District: Date: Please date this form and type the name of the District President or Trustee prior to submitting it to the MDA. A curriculum vitae and other information may accompany this form. Please mail nomination materials to the Minnesota Dental Association, 1335 Industrial Blvd, Ste 200, Minneapolis, MN 55413, fax to (612) 767-8500, or email: . you.
2018-Candidate-Nomination-Form-1.docx