Council Nominee Application Form

Council Nominee Application Form
PEI Dental Hygienists' association (PEIDHA)

The Nominations Committee of the PEI Dental Hygienists’ Council is required to present a slate of Nominees to the Annual General Meeting of the PEIDHA. To help the Committee match talents, skills, experiences, and interests with the needs of the Council, we would appreciate knowing a little more about you.

Please complete the following:

Street # and name/ PO Box / City / Postal Code / Province
Street # and name/ PO Box / City / Postal Code / Province
Provide cell phone, home phone, and work phone if available