Dear Valued WDA Member,

The award-winning Mentor Program is a collaborative effort between the Wisconsin Dental Association, Marquette University School of Dentistry and the Pierre Fauchard Academy and is one of the most important programs we offer. The Mentor Program is entering its 25th year and continues to be rated among the best in the country. We believe a major factor in successfully entering the profession is meaningful mentorship. Frequently, students identify a need for professional guidance, and we need your help to provide that to them.

We invite you to consider becoming a mentor. We believe you will find it to be a worthwhile and rewarding experience for both you and your student protégé(s).

If you are interested in volunteering as a mentor, please complete the form below and save the date for this year's Annual Kick-Off Dinner on Monday, Sept. 30, 2019 at the Marquette University Alumni Memorial Union.

An official invitation and response form for you and your student protégé(s) will be sent this summer.

Contact Betsy Krekling with questions at 414-755-4118 or bkrekling@wda.org.

Thank you, in advance, for your time and your commitment!

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* 1. First and last name

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* 2. Email address

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* 3. I am willing to mentor...

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* 4. I practice in a 

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* 5. Please check all that apply to you

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* 6. Please select which specialty best describes you

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* 7. Please check below areas of work that may apply to you

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* 8. Are you a left handed dentist?

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* 9. Please list any special requests (e.g., male/female, want/don't want to specialize, from certain area of state, specific student) and we will do our best to meet your requests:

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