Membership

Student/Affiliate Member Application

  • Your Name
  • Personal Information
  • Education/Practice Profile
  • Membership Type
  • Payment

Thank you for strengthening the voice of general dentistry by joining the AGD!

With your new membership, you’ll have access to these great benefits:

  • Convenient online learning through podcasts, case studies, and blogs
  • Subscriptions to award-winning publications General Dentistry and AGD Impact
  • Discounts on professional products and services designed to help you prepare for dental career
  • And more!

Please feel free to contact the AGD Membership Services Center at 888.243.3368 or membership@agd.org. if you have any questions while filling out the application.

If you prefer, you can download one of the applications below and mail or fax it to the AGD.

Attention Current AGD Members: If you would like to renew your AGD membership, please visit the online renewal application.

STEP 1: Contact Information

Title First Name Required field   M.I.   Last Name Required field   Designation

Preferred Name (if different than above)

Primary E-mail Address Required field

Preferred Billing Address Required field Permanent Address School Address

The location of your dental school will determine your local constituency as a student member.

Preferred method of contact     

Permanent Address
Address  
   
City  
State/Province  
Zip/Postal Code  
Country  
Phone  

School Address
Address
   
City
State/Province
Zip/Postal Code
Country
Phone
Fax
Web site http://

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