BECOME A MEMBER
We sincerely hope that you will consider becoming a member of the oldest dental society in continuous existence in the United States. We are here for one simple reason... to offer the highest quality continuing dental education at a reasonable cost to our members. Our yearly membership dues entitles members to attend our Annual Event at no extra charge! The two day program offers 13 credits of great continuing education.
To join our society, simply print this page, fill in the information and mail it with a check for $100 (Made out to NEDS) to:
Dr. Richard Berryman18 Foxcross CircleConcord, New Hampshire 03301Please note: You must be a member of the ADA and a New England state dental society or association to belong to the New England Dental Society.
I, ________________________________________ do hereby apply for active membership in the New England Dental Society and should my petition be granted,
I promise cheerful compliance to the Constitution and By-Laws of said society.
Date:
Name: Degree:
Office Street Address:
City: State: ZIP:
Dental School: Class of:
ADA Membership # :
State Dental Society or Association: CT ME MA NH RI VT
Your Signature ________________________________________________________
Membership Application
New England Dental Society
