Apply for WSDA/ADA Elected Positions

The following WSDA and ADA elected positions are up for election at the 2020 House of Delegates in September:

  • President-elect (1 position)
  • Board of Directors (4 positions)
  • Delegate to the ADA (3 positions)
Expand below to learn more and see requirements for each position, and fill out the form on this page to apply.

Application Deadline: June 30, 2020

  • Position Details


Personal Information

Home or office address?

Cell, office, or home phone?

Do you have a Board Certified specialty?

Current Positions (Limit 5)

Former Positions (Limit 5)

Professional Affiliations (Limit 5)


Other (Limit 5)

Office & Candidate Statement

Candidate Photo

Please upload a high-quality headshot.

Conflict of Interest

Applicants must read WSDA's Conflict of Interest Policy prior to submission. 

WSDA Conflict of Interest Policy
I have read and understand WSDA’s Conflict of Interest policy as stated in Bylaws IV.I (4.I) and Standing Rule 4.4.