Mailing Labels
Please note: AzDA's policy does not allow an electronic version of the mailing labels to be purchased. For example: labels in an excel spreadsheet, on a disk or in an e-mail.
Name of Company
*
Authorized Agent and Title
*
Contact Phone Number
*
Email
*
example@example.com
What is the purpose of your request for the mailing labels?
*
I am
*
Please Select
A member dentist of AzDA
A dentist not a member of AzDA
An AzDA Endorsed company
An AzDA Business Affiliate
Other
If a member dentist of AzDA, what is your name?
If a member dentist of AzDA, what is your ADA Number?
Please specify who you are:
What geographic area are you requesting labels for?
*
Please Select
All of Arizona
Northern Arizona
Central Arizona
Southern Arizona
Other (describe in the "purpose of mailing" box above)
Which group of dentists are you interested in?
*
Please Select
All Dentists
Only Active Dentists
Only Retired Dentists
New Dentists (1-10 years out of Dental School)
Which specialty would you like?
*
Please Select
All Dentists
Endodontists
General Practice
Oral Surgeon
Orthodontist
Pediatric
Periodontist
Prosthodontist
Upload the document you will be mailing to AzDA's members
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: