IADT New Member Application


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Member Overview / Summary
Contact Info Email Address needs to be updated:
Contact Info Mailing Address needs to be updated:
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Contact Email Address:
Affiliation:
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Current Amount Due: $        
Make a Donation:
Access to 2018 WCDT Lectures:
Contact information made available on the IADT Find a Dentist tab:
Member Classification
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LDC - Lower Developed Country discounts will be applied on the payment page


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Contact Information
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Uncheck the following box if you do not want to be listed on the IADT Find a Dentist tab*  
Dental Traumatology Journal Information. Complete this address for DTJ delivery
Mail Address
Same as Contact Information?
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Journal Request History
* To change your mailing address on an existing order below, click 'Edit Address' which will load the address above.
* Then click 'Save Updated DTJ Address'
Affiliation Information
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Department:
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Personal / Private Practice Website URL:
Member Photos

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Member Registration Payments
Membership Dues for 2023






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Member Classification Change Request.
Fill out your comments below about why you wish to change. Click [Request Change] next to the Classification below that you wish to change to. The Membership Committee will review your request for consideration.
Comments:
 Classification
Administration (Annual Dues: $0 , Includes DTJ: No)
IADT Fellow (LDC) (Annual Dues: $120 , Includes DTJ: No)
IADTube One Lecture Purchase (Annual Dues: $49 , Includes DTJ: No)
Access to ONE lecture for a period of 30 days
Membership with Online Journal (Annual Dues: $235 , Includes DTJ: No)
Membership includes online access to journal Dental Traumatology
Student (Annual Dues: $75 , Includes DTJ: No)
Student must be currently enrolled in a resident or student program and requesting to change membership to student status.Membership includes online access to journal Dental Traumatology



IADT - International Association of Dental Traumatology
IADT - International Association of Dental Traumatology



IADT - International Association of Dental Traumatology
APPLICATION FOR FOUNDATION FELLOWSHIP


Family / Last Name:
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Name to appear on Fellowship certificate:   
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USD $250 Foundation Fellowship Fee
Total Amount: $
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Phone: (858) 272-1018        Fax: (858) 272-7687        E-mail: membership@iadt-dentaltrauma.org        Website: www.iadt-dentaltrauma.org



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