Arizona - American Student Dental Association

American Student Dental Association
2009-2010 Ideal ASDA Application
2010 Ideal ASDA Chapter Awards Application Form
The Ideal ASDA Chapter Award honors outstanding achievements by ASDA
chapters in serving members in accordance with the Ideal ASDA Chapter
criteria.
Chapter:
Your Name:
Email address:
Phone:
Arizona School of Dentistry and Oral Health
Elif Aksoylu
[email protected]
480-297-9813
AWARDS
Your application must include this page, a one page description of the chapter’s achievements
in the award categories you are applying for and supporting material as needed. You may
apply for more than one award (please check all categories below).
A
B
C
D
E
F
G
H
I
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Award for Ideal ASDA Chapter
Award for Most Improved Chapter
Award for Outstanding Membership & Communication
Award for Outstanding Involvement with Organized Dentistry
Award for Outstanding Activities
Award for Outstanding Advocacy
Award for Outstanding Fundraising
Award for Outstanding Involvement with Predental Membership
Award for Increasing Ethical Awareness
* Awards will also be presented to chapters with the largest membership market share, largest
increase in member market share from 2009 to 2010, and schools that implement an automatic
billing system. Chapters do not need to complete an application for these awards.
Eligibility
The 2010 Ideal ASDA Chapter Awards are open to all ASDA chapters.
Constitution and Bylaws must be on file with the central office.
Awards are given to chapters, not individuals.
Programs must have been conducted between April 1, 2009 and February 2010. (Ongoing
activities may have been initiated prior to that period as long as results can be measured during
the 2009-10 academic year.)
Deadline
Applications (hard copies and electronic) must be received in the central office by Monday,
February 22, 2010.
Submission Guidelines
Please follow guidelines exactly. Entries not following guidelines will be DISQUALIFIED.
All entries must be typed.
The first page must be the official entry form (this page)
If you are applying for the Ideal ASDA chapter award or most improved chapter award, the first
seven pages (not including the entry form must be in BULLET format.
One page per category:
Pg 1 = Membership & communication
Pg 2 = Involvement with organized dentistry
Pg 3 = Activities
Pg 4 = Advocacy
Pg 5 = Fundraising
Pg 6 = Predental
Pg 7 = Ethics
You may attach supporting material as needing after the completed application. Important: judges
have only a few minutes to review each application. A picture can be worth a thousand words.
If you are applying for an individual award, you are limited to one BULLET formatted page per
category. You may submit as much supporting material as needed following this page.
Chapters may submit nominations for more than one category.
Applications may not be longer than 50 pages total (25 two-sided or 50 single-sided)
Each page of your application must be scanned into a pdf (Adobe Acrobat file) and emailed to
Danielle Bauer ([email protected]). A hard copy must be sent to central office as well.
Both the electronic and hard copy of your application must be received by the March 1st
deadline.
Judging
Judging is based on standards of excellence as itemized in the Ideal ASDA Chapter criteria (see
criteria below). The Ideal ASDA chapter scoring log contains complete criteria information.
The Ideal ASDA Chapter Committee will judge entries during Annual Session.
Winners will be announced and presented with a personalized award certificate during the Ideal
ASDA Chapter Awards Luncheon at Annual Session.
Award Categories
Chapters may submit nominations for more than one category. Below are the guidelines and
criteria for each category.
A. IDEAL ASDA CHAPTER AWARD
One award will be given to the chapter that best exemplifies the characteristics of an
Ideal ASDA chapter.
Explain in bullet format how the chapter has achieved the Ideal ASDA Chapter criteria in
items C-I below.
Each category must be addressed on a separate sheet of paper in bullet format.
Excluding this entry form & supporting materials, your application should total 7 pages.
Supporting material, such as activity calendars, meeting minutes, chapter newsletters,
photos, or other related materials can be attached to the end of this application.
B. MOST IMPROVED CHAPTER AWARD
One award will be given to the chapter that has shown the most progress toward
achieving the Ideal ASDA Chapter criteria.
Specific improvement must be noted in bullet format in sections C-I. Highlight new
factors that led to improvement.
Each category must be addressed on a separate sheet of paper in bullet format.
Excluding this entry from & supporting materials, your application should total 7 pages.
Supporting materials, such as activity calendars, meeting minutes, chapter newsletters,
photos, or other related materials can be included to the end of the application.
C. Membership & Communication
100 % membership
Chapter utilizes electronic remittance procedures
Chapter encourages member participation
Chapter recruits and provides activities for predental members
Chapter employs the following communication vehicles: class announcements, bulletin
boards, e-mail, Web site
Chapter publishes a local newsletter at least three times per school year
Chapter contributes to national ASDA publications
Chapter utilizes ASDA branding (including ASDA signage and the ASDA member
benefit PowerPoint slide)
D. Organized Dentistry
All seniors know how to join ADA after graduation
100 percent of members convert to ADA membership in the year after graduation
ADA SUCCESS Program scheduled & given for first, second, third and fourth years
Chapter is involved with state and/or local dental society
Chapter has voting representation in the state dental society House of Delegates
Chapter has representation on state dental society councils.
Chapter contributes to local and/or state society publications
Chapter has Tripartite Grassroots Membership Initiative representative
E. Activities
Chapter offers professional or educational programs for interaction between students &
faculty, staff, state/local dental societies
Chapter offers tutoring/mentoring
Chapter organizes vendor fair
Chapter organizes lunch/dinner & learns frequently
Chapter provides social activities
Chapter interacts with other ASDA chapters in region through activities
Chapter participates in community or humanitarian activities
Chapter organizes activities that are unique and original
F. Advocacy
Acts as a resource for information on financial aid and other pertinent issues
Provides mentoring services for new members such as explaining requirements,
providing class notes or preparing test booklets
Supports the individual and collective concerns of members
Serves as voice for entire chapter membership
Attends State and National Lobby Days
Holds ADPAC drives
Attains at least a 20% ADPAC membership within chapter
Present ASDA’s initiatives, such as Access to Care and Mid-level Providers, to members
Attains >80% enrollment in ADA’s free $50,000 life insurance benefit
G. Fundraising
Chapter conducts one or more organized efforts at earning money
Chapter’s efforts at raising money are successful
Chapter’s fundraising contributes to annual expenses
H. Predental Membership
Chapter recruits predental members for national ASDA membership
Chapter introduces predentals to dental school and organized dentistry (ASDA & ADA)
Chapter provides leadership opportunities for predentals
Chapter provides networking opportunities for predentals w/ dental students & dentists
Chapter provides mentorships for predentals
I. Ethics
Students in your chapter are represented on ethics committees at your school
Organizes activities focusing on ethics, such as lunch and learns
Develops resources on ethics for your chapter
Relationship with student ethics organizations at your school, such as the Student
Professional Ethics Club
Displays Code of Ethics prominently at chapter (web site, newsletter, bulletin boards,
etc.) and distributes Code to members of chapter
Publish articles in chapter newsletter and on web site focused on ethics
Faculty involvement in ethics activities
MEMBERSHIP
&
COMMUNICATION
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100% Membership
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Full membership annually since ASDOH was founded in 2003
Chapter utilizes electronic remittance procedures to ensure timeliness and
met the deadline set out by Brett Swanson of November 24th 2009.
Chapter encourages member participation
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School-wide E-vites for all events
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School-wide emails sent by ASDA leadership to update students
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ASDOH ASDA Forum for ASDOH and pre-dental students
Chapter recruits and provides activities for Predental members
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First Annual Pre-Dental Fair – February 2010
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Pre-dental Newsletter - monthly
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Pre-dental mentor-mentee program - ongoing
Chapter employs the following communication vehicles:
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Class announcements: representatives for each dental class
provide monthly updates
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ASDOH ASDA bulletin boards
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ASDA school wide E-mail
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Web site: http://asdohasda.org/
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Facebook Group with over 120 members
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Annual All-Chapter meeting
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Formation and participation of Committees
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Monthly ASDA council meetings
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“Introduction to ASDA” Lunch-and-Learn for first year students
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First year officer elections
Chapter publishes a school-wide newsletter 3-4 times per school year:
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The Lingual Groove
Chapter contributes to national ASDA publications
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Katie McNutt – Contributing Editor to ASDA News & Mouth
magazine
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Jennifer Logigian – Contributing Editor to ASDA News
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Israel Armijo – ASDA News
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Dr. Hartfield (ASDOH Faculty) – ASDA News
Chapter utilizes ASDA branding
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3 ASDA banners
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ASDA member benefit PowerPoint slide
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ASDA slides on school-wide TV screens
INVOLVEMENT
WITH
ORGANIZED
DENTISTRY
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All seniors know how to join ADA after graduation
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Informational email sent to all D4 students about the American
Dental Association and life insurance continuance
80 % of members convert to ADA membership in the year after
graduation
ADA SUCCESS Program scheduled & given for first, second, third and
fourth years
Chapter is involved with state and/or local dental society
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AzDA involvement
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Carl Wright, D4 – student board member for Arizona AGD
Chapter has voting representation in the state dental society House of
Delegates
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Damon Thielen is a voting member and state dental liaison who
attends meetings within the House of Delegates
Chapter has representation on Arizona State Dental Society councils
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All students attended Western Dental Convention
Chapter contributes to local and/or state society publications
Chapter has Tripartite Grassroots Membership Initiative representative
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Nicole Chung – led ADPAC drives to encourage ASDA members
to join ADPAC
ACTIVITIES
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Chapter offers professional or educational programs for interaction between
students & faculty, staff, state/local dental societies
Chapter offers tutoring/mentoring
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Chapter organizes vendor fair
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Didactic courses and Head & Neck Course
Mentor-Mentee Program for Predentals
4th Annual Vendor Fair – March 2009
5th Annual Vendor Fair – March 2010
Chapter organizes lunch/dinner & learns frequently
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Career development Lunch’n’Learns
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Business development Lunch’n’Learns
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Johnson & Johnson
Heartland
Treolar & Heisel
Fuji LC
AFTCO
Northstar Financial dinner’n’learn
Chapter provides social activities
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Financial Planning
MedProtective
Professional Financilists
Lutheran Medical Center Dept. of Dental Medicine
Pacific Financial Services
Western Dental
Dental Product Lunch’n’Learns
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Secrets of a successful dentist:
What to look for in Residency programs
American Academy of Periodontists
Arizona Academy of General Dentists
Specialty 101 Student Panel
AzDA Annual Boo Bash (for ASDOH and Midwestern Students)
Inter-school socializing – District 10 Regional Conference, Western Regional
conference.
Social Activities: Root Planing & Ice Skating, V-day Ski trip, Ice Cream social
“Brux the Night Away” Dental Prom
“In memory of Michael Serkanic” Football Tail-gating Party at Arizona State
University
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Mike Serkanic was a dental student at ASDOh who passed away in his
D4 year and will be forever missed but forever remembered.
Chapter interacts with other ASDA chapters in region through activities
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Interaction with other ASDA chapters - District 10 meeting, Western regional mtg,
AzDA Annual Boo Bash
Chapter participates in community or humanitarian activities
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Operation Christmas Child, GKAS, Shelterboxes for Haiti
Chapter organizes activities that are unique and original
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Root Planing & Ice Skating, Valentines Day Ski Trip, Specialty 101 Student Panel,
“In memory of Michael Serkanic” Football Tail-gating Party at ASU.
ADVOCACY
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Acts as a resource for information on financial aid and other pertinent issues
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Provides mentoring services for new members such as explaining
requirements, providing class notes or preparing test booklets
… 
All members participate in D2-D1 mentor-mentee program and D3D4 mentor mentee clinic program
Supports the individual and collective concerns of members
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Class representatives relay concerns to ASDA council
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Concerns can be presented on website forum
Serves as voice for entire chapter membership
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Council members range from D1 through D4; therefore, all council
members serve as eyes and ears of concerns and questions of all
ASDA student body
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Jacqueline Clary – Member at large
Attends State and National Lobby Days
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Damon Thielen
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Nicole Chung
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David Neal
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Lillie Pitman
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Seena Patel
Holds ADPAC/ArDPAC drives
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Nicole Chung organizes these annual drives
Attains at least a 20% ADPAC membership within chapter
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33% of the ASDOH ASDA member body are ADPAC members
Present ASDA’s initiatives, such as Access to Care and Mid-level Providers
to members
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Lunch’n’learns
Brown Bag lunches with Financial advisors
Through Lunch’n’Learns forums
Attains >80% enrollment in ADA’s free $50,000 life insurance benefit
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97% of ASDOH ASDA member body has ADA life insurance
FUNDRAISING
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Chapter conducts one or more organized efforts at earning money
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Bi-annual Clothing sale – ASDOH logo is screen printed or
embroidered on t-shirts, sweatshirts, zip-up hoodies, and
children’s clothing
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Annual Scrubs sale- ASDOH logo is embroidered on scrubs
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CPR fundraiser- organized multiple times per year
Chapter’s efforts at raising money are successful
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Chapter’s fundraising efforts pay for the majority of our events and trips
Chapter raised over $15,000 in fundraising this year
Chapter’s fundraising contributes to annual expenses
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Pre-Dental Fair
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over $1,500 in profits
Lunch’n’Learns
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At least $200 profit per lunch’n’learn we schedule
At least 2 lunch’n’learns are organizes per month
Lunch’n’Learns during this past year
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Secrets of a successful dentist:
What to look for in Residency programs
American Academy of Periodontists
Arizona Academy of General Dentists
Financial Planning
MedProtective
Professional Financilists
Lutheran Medical Center Dept. of Dental Medicine
Pacific Financial Services
Western Dental
Johnson & Johnson
Heartland
Treolar & Heisel
Fuji LC
AFTCO
Northstar Financial dinner’n’learn
Annual Vendor Fair
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Over 45 vendors travel from all around the country each year.
The rate per single booth (8' x 10') is $500. Booths will be
available from 11am until 2pm and can expect over 300
students and faculty participating from ASDOH.
All ASDOH students attend Vendor Fair each year; however this
year, in addition to the 250 ASDOH students attending Vendor
Fair – 200 Midwestern Dental students will attend.
PREDENTAL
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Chapter recruits predental members for national ASDA membership
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Actively contacts predental societies at universities
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ASDOH ASDA Predental Committee informs all predental societies about
national ASDA membership
Robert Trujillo – Predental Chair – contacts 15-20 predental societies all
around the US to offer ASDA mentor program, ASDA predental forum, and
many more opportunities for predental involvement with ASDOH.
Chapter introduces predental students to dental school and organized
dentistry (ASDA and ADA)
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Predental Workshop – February 2010 –
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predental students in attendance participated in AADSAS application
and personal statement workshops, sim-clinic operative workshops
where they wax teeth and prep teeth in a typodont, tour of the school,
mock interviews, practice DAT exam, and dental student panel.
Over 40 pre-dental students from around the US attended!
ASDOH ASDA Website Forum – contains special Predental
section for questions and advice
Chapter provides leadership opportunities for predentals
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Monthly Predental Newsletter
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Predental website Forum
Chapter provides networking opportunities for predentals with dental
students and local dentists
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Predental workshop allows participating students to meet with
current students and faculty
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Predental mentor/mentee program connects predental students
with current dental students
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Predental Committee invites predental students to volunteer at
GKAS to network with local dentists and experience dental
service projects
ETHICS
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ASDA students are working to for SPEC club on campus
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Received administrative approval
Determined our advisor: Dr. Donald Altman
Working on first meeting and determining the founding members.
Displays Code of Ethics prominently at chapter (web site, newsletter,
bulletin boards, etc.) and distributes Code to members of chapter
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Code of ethics on bulletin board
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Code of ethics are emailed to all members of chapter
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Code of ethics is displayed on website
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White Paper on Ethics emailed to each student at ASDOH and
displayed on bulletin
Membership & Communication
ASDOH has 100% ASDA
Membership since ASDOH opened
its doors in 2003.
ASDOH has 97% of its students
enrolled for ADA’s Term life
insurance!
Esther Kim, Membership Chair, ensures that ASDOH ASDA chapter is
current in its membership information by utilizing electronic remittance
procedures and making sure to meet all member deadlines this year. She
has made our chapter $500 in doing so!
Membership & Communication
All ASDA members are encouraged to
participate through many fun vehicles!
School-wide
emails
All-school Forum
School-wide
Evites…
Membership & Communication
ASDOH entices pre-dental students through the use of….
Informational
Pre-dental
newsletter
Launched online
Pre-dental Forum
November 2010
ASDOH’s First
Pre-dental
Workshop
February 2010
Membership & Communication
In addition to the ways that ASDA officers
encourage participation, other communication
methods used include but are not limited to:
Image: Elliott
Brennan (Left, D2)
dressed up like
Dean Dillenbergstanding with Dr.
Bell, Vice Dean
(right).
ASDOH’s first ASDA website was
created this year:
http://www.asdohasda.org
ASDOH
ASDA member
Facebook page
launched November
2009 and already
has over 120
members!
Membership & Communication
More ways ASDOH ASDA Council communicate ….
Annual All Chapter Meetings
bring the entire chapter
together to discuss the year’s
coming events and form
committees!
ASDA Banners are
proudly displayed at every
ASDA event.
Monthly Council Meetings
take place in order to keep
business running!
Membership & Communication
ASDOH ASDA
publishes The Lingual
Groove at least three
times a year!
It is full of local dental
news and covers
aspects of ASDOH
student life.
ASDOH is proud to have many of their ASDA members and
faculty contributing to national ASDA News publications.
Dr. Todd
Hartsfield
Israel
Armijo
Katie
McNutt
Jennifer
Logigian
Involvement with Organized Dentistry
Below are some of the more
than 80% of ASDOH Class of
2010 graduates that will join
ADA this coming year.
Carl Wright, D4, is the
ASDOH student
representative for the
Arizona Academy of
General Dentistry.
Damon Thielen,
D3 Voting
member & State
Dental Liaison
within the House
of Delegates.
Involvement with Organized Dentistry
Attendees at the Western
Regional Dental Conference
Nicole Chung, D3,
encourages ASDA
members to join ADPAC,
Tripartite Grassroots
Membership Initiative.
Involvement in Organized Dentistry
Arizona Dental Association sponsors an Annual Boo Bash
for all Arizona dental students to learn more about AzDA
Vendors from around
the state present their
products and services
throughout the night (in
costume of course!)
ASDA students attend the
American Education
Dental Association
Conference each year.
Activities
Arizona Dental
Association sponsors
an Annual Boo
Bash!
A chance to
meet and
interact with
AzDA
members and
Midwestern
dental
students!
Activities
ASDA District 10 Meeting
January 2010
Las Vegas, Nevada
ASDOH sent 8 students to this meeting!
Western Regional Meeting
St. Louis, Missouri
October 2009
ASDOH sent its 1st delegate to this meeting!
Activities
ASDA Ice Cream Social
September 2009
“In Memory of Michael Serkanic”
Tail-gating Party
October 2009
Over 60 people in attendance!
Activities
Root Planing & Ice Skating Social
December 2009
Activities
Operation Christmas Child
Community Service Project
November 2010
Activities
100% of ASDA members and many pre-dental students
participate in Give Kids A Smile Day every year….
April 2009
Activities
ASDOH organizes at least 2 Lunch’n’Learns each month to inform
students about all the dental opportunities there are in the world!
Johnson
&
Johnson
Lunch’n
’Learn
Fuji LC
All About
Biotene!
Financial
Activities
“Brux the Night Away” Dental Prom – February 2010
Over 150
students and
guests in
attendance!
Advocacy
ASDA students are represented at State & National Lobby
days… (through rain or SNOW, nothing stops them!)
More than 30% of the
ASDOH ASDA Students
are ADPAC members.
Nicole Chung, D3 – running the ADPAC/ArDPAC
table during lunch.
Advocacy
Northstar Financial
Lunch’n’Learn taught
ASDOH ASDA members
about asset protection and
provided financial advice.
Professional Financial
Specialists, Inc (PFSI) &
Disability Income Specialists
(DIS) spoke about
comprehensive insurance
services including malpractice,
life, and disability.
Medical Protective
Lunch’n’Learn provided
information about
malpractice insurance.
Advocacy
Class Representatives:
Jessica Nguyen (D2, left)
& Brian Huh (D1, right)
work hard as the liaisons
between their class and
ASDA council.
Jacqueline Clary,
D3 – Member at
Large. She travels
to ASDA National
Meetings!
ASDA members
often mentor other
students and offer
advice about classes
and clinic.
Fundraising
ASDOH’s efforts at raising
money has increased profit
within the past year.
Stephanie Canton, D2,
ASDA Fundraising Chair
Andi Livingood,
D3, ASDA Treasurer
ASDOH ASDA organizes regular CPR
classes for ATSU students and faculty
to refresh their CPR skills and renew
their license.
Fundraising
ASDOH Logo/Scrubs
Fundraiser
ASDOH Sweatshirt
Fundraiser
Hundreds of
dollars raised for
style you cant put
a price on! 
Fundraising
Vendor Fair
The ASDA chapter at ASDOH is
hosting the 5th Annual Vendor Fair on
Wednesday, March 3, 1020. Booths
will be available from 11am until 2pm
and can expect over 300 students and
faculty participating from ASDOH. In
addition, we will be extending an
invitation to the students attending
Midwestern University School of
Dentistry, which consists of over 200
students. There will be a raffle for
ASDA members who participate in the
Vendor Fair. The 4th Annual Vendor
Fair in 2009 was a resounding success,
drawing 29 vendors from all around the
country.
Fundraising
Lunch -n-Learns
Lutheran Medical Center
Dept. of Dental
Medicine
Professional
Financial
Specialists
AZ Academy of
General Dentists
Treolar & Heisel
Fundraising
Lunch-n-Learns
AFTCO
fa
Secrets o tist:
ul Den
Successf
hy
Abernat
e
k
i
M
.
r
D
Dinner’n’Learn with
Northstar Financial group
Predental
ASDOH Chapter produces a Predental Newsletter at least 3
times a year that includes volunteer opportunities at ASDOH
and in the community, as well as dental application tips, etc.
ASDA members participate as mentors to interested
Pre-dental students throughout the United states via
email and lunch dates to answer questions and offer
advice about dental school.
Predental
Over 40
predental
students
attended!
The workshop included
mock interviews,
practice DAT exams,
application and personal
statement workshops,
and a hands-on sim
clinic component where
students prepped and
waxed up teeth!
ASDOH organized the first Pre-dental
workshop on February 7, 2010! The
workshop introduced predentals to dental
school and organized dentistry.
Predental
Breakfast, lunch, and dinner was served
with for predental students to network with
ASDOH students and faculty.
Student Panel took place
for pre-dental students to
ask questions.
Predental
The ASDOH website has a PreDental section on the forum to
answer questions and offer advice
to pre-dental students.
ASDOH Open House –
an opportunity for predental students to come
and learn about the
ASDOH program and
tour the campus! ASDA
members serve as student
ambassadors for these
programs.
Ethics
The ASDA Student
Code of Ethics is
displayed on our
website.
This year we received
administrative approval
for formulation of SPEC
club at ASDOH,
determined the club’s
advisor Dr. Don Altman
and is currently in the
process of organizing the
first meeting and
determining the founding
members!
ASDA ASDOH Chapter Website
http://www.asdohasda.org
THANK YOU
ASDA ASDOH Chapter Council
2009-2010