NNOHA Committee Application
Committee Applications are reviewed on a quarterly basis. Acceptance into a NNOHA Committee is based on the availability of positions within each committee.

The mission of National Network for Oral Health Access (NNOHA) is to improve the oral health of underserved populations and contribute to overall health through leadership, advocacy, and support to oral health providers in safety-net systems. NNOHA often seeks members to join NNOHA committees. If you are interested in joining a committee, please complete this form. A NNOHA staff member will reach out to you. Committee chairs will review applications and determine which committees may be of best fit for the applicant. Committees may have caps on the number of members and will only accept if there are vacancies available. Responses are checked on a quarterly basis. You will only receive an email if accepted into a committee.

Responsibilities and Requirements:
1. Knowledge of the organization and personal commitment to its goals and objectives. Please reference NNOHA's Strategic Plan at www.nnoha.org/goals.html
2. Must be an active member of NNOHA, paying regular membership dues.
3. Regularly attend committee meetings and activities.
4. Volunteer for and willingly accept assignments and complete them in a thorough and timely manner.
5. Stay informed on committee matters, be well prepared for meetings, review and comment on minutes and reports.
6. Network and meet committee members and build a collegial working relationship that contributes to consensus.
7. Become an active participant in the committee's annual evaluation and planning efforts.
8. Follow the requirements outlined in the committee charter.

NNOHA Committees:
Please review the descriptions of the committees at http://www.nnoha.org/about-nnoha/committees/
1. Membership
2. Practice Management
3. Quality
4. Continuing Education Advisory
5. Policy and Advocacy
6. Conference Planning
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Email *
Name
Organization Name
Position at organization
Address
City
State
Zip Code
Phone Number
Email Address
Are you a NNOHA Member? Committee members must be active NNOHA members upon application.
Clear selection
Please rank the committees you are interested in: (1 most interested). If your first choice is full, your application will be sent to the open committees. Applications are reviewed on a quarterly basis. *
Practice Management
Quality
Membership
CE Advisory
Policy and Advocacy
Conference Planning
1
2
3
4
5
6
Briefly describe your involvement(s) to date with any committees, workgroups, learning collaboratives, or other activities with NNOHA.
Briefly state your topics of interest and what contributions you will offer as a member of the NNOHA Committee.  250 word max.
If NOT an FQHC provider, describe your activities, which promote oral health access for the low income, migrant or homeless populations served by Health Centers. 250 word max.
Provide any further information that is considered appropriate to support this nomination. 250 word max.
A copy of your responses will be emailed to the address you provided.
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