Annual Report

AADOM Local Chapter Annual Report
Chapter Name:*
Name*
First Last
Please provide the names and titles of your current board members.*
Please provide the names of your chapter members. (Silver Chapters - include all chapter member names)*
If you would prefer to upload a roster of members, please do so at the bottom of the form and note that you are uploading this in the field above.
What will your local chapter dues rate be for 2023? If $0, please indicate that below.*

Please list the meeting dates of your chapter meetings held in 2022. Please do not include any cancelled meetings.*
Please provide the dates of planned chapter meetings for the upcoming year (minimum of 4 required). Virtual meetings are an option for 2 of your meetings in 2023. If the details are available for each date, please indicate if the meeting is a roundtable session or a featured speaker event. AADOM National will promote ALL of your meetings via email to our database, as well as social media posts.*
These will be listed in a Save the Dates section of your chapter webpage. Notify us if your dates change during the year.

Previous Year Sponsors and Support Description. Please provide a list of sponsors who supported your chapter and in what manner during the past year. Examples: ABC Dental Company provided financial contribution of $1500. 123 Dental Lab provided meeting venue, snacks and sponsored a speaker.*
Upcoming Year Sponsor Support. Please list all confirmed sponsors for the upcoming year. The founding sponsorship logo will be shown on the chapter web page and the supporting sponsors will be listed below the founding sponsor logo.*
Chapter Vision Statement. A Vision Statement describes the desired future position of the chapter. We will add your mission statement to the AADOM chapter webpage.
Chapter Mission Statement. A Mission Statement defines the chapter's purpose, its objectives and its approach to reach those objectives. We will add your mission statement to the AADOM chapter webpage.
Chapter Email Account Address:*
Chapter Facebook Page URL (if applicable):
Chapter Instagram Account URL (if applicable):
Chapter Twitter Account URL (if applicable):
Chapter YouTube Account URL (if applicable):
Chapter LinkedIn Account URL (if applicable):
Chapter Google Maps Page URL (if applicable):
Chapter Website URL (if applicable):
Upload chapter member roster, sponsor roster, etc here.
Drop files here or

Max. file size: 100 MB.
Name
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