MVMA Power of Ten Leadership Academy Application

You’ve mastered medicine, now it’s time to grow your influence. The Power of Ten Leadership Academy (POTL) is built for early-career veterinarians who want to strengthen their leadership, communication, and community impact. Step into your next chapter with a network that inspires and supports you.

A letter of recommendation is suggested but not required. Enrollment is limited to 10 MVMA members annually. There is no cost to participate and MVMA will provide speakers and food for attendees.

We are excited to welcome you as an applicant for this program and are happy to answer any questions you might have. Please feel free to contact Kara Henrys any time at 517-347-4666 or henrys@michvma.org.

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* 1. Please Complete

Name + Credentials *

Preferred Email

Cell Phone *

Alma mater

Year of Graduation *

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* 2. Emergency Contact

Name

Cell Phone

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* 3. Please share any dietary restrictions we should be aware of.

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* 4. If selected for the Academy, we’d like to share your contact information with your POTL colleagues. Please provide your employment information below, including the name of the practice owner, the address, and practice where you’re employed.

Practice Name

Practice Owner

Street Address

City/State/Zip

Daytime Phone

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* 5. Briefly express why you’re interested in participating in the POTL.

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* 6. List organizations, clubs and/or committees in which you actively participate or held office, recently or in veterinary school.

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* 7. Please share a short bio we can share with leadership and your colleagues.

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* 8. Please share a picture that can be used with your bio and in future program promotion and education. If possible, in a format that is 300 DPI or higher, and/or large in scale.

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* 9. The POTL consists of 5 sessions, 4 of which are in-person. Attendance to 4 of the 5 sessions is required to participate and graduate. While we understand life happens, we request that you commit to this timeframe as best you can in order to make the most of your time with us.

I understand the participation requirement.

Other (please specify)

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* 10. Optional: Please share any details with us that would make your time in the MVMA Power of Ten Leadership Academy the best it can be. Thank you again for your interest!