Initial Membership Application

Initial Membership Application
Thank you for your interest in becoming a member of the American Academy of Dental Hygiene Inc.! We look forward to reviewing your application. Submission of application is not a guarantee of membership. All applications are screened by the Membership Committee and then forwarded to the Governing Council for final approval. You will receive notification of final membership status. This process may take up to 4-6 weeks. If you have questions regarding the application process email Danni Gomes at admin@aadh.org.
Application Fees:

$35.00 Non-ADHA Member $25.00 ADHA Member
Membership Dues:

$175.00 Non-ADHA Member $125.00 ADHA Member
Submission requirements checklist:
Date of Application:
Today's Date
Name:

First NameLast Name
Credentials:
Credentials
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SMS Number:

Area CodePhone Number
Email Address:
Please avoid using an email address ending in .edu so our emails won't get blocked
Birthdate: (optional)

MonthDayYear
Date
How did you hear about AADH?
Who should we thank for referring you?
Please provide 3-5 lines describing your career philosophy and/or experiences.*
Upload headshot (optional) *used to recognize you on our website and/or social profiles.
Enter Instagram username here (if applicable) so we can tag you on post

Professional Career Experience:

Please provide the following information for each applicable experience:
Continuing Education Course Listing:

Continuing education is defined as non-degree credit bearing courses for adults, regardless of previous education, offered by a university, institute or provider which is recognized as adjunctive or belonging to the practice of dental hygiene. Minimum of seventy-five (75) credits are required, that must meet AADH course approval requirements and/or other CE official approving organization (i.e. ADA, PACE). Only twenty-five (25)% of the total hours can be given by the applicant.
Complete the CE Course Spreadsheet below:
Click here to complete the CE Course List

Nonrefundable Membership Application & Dues Payment:

Please submit the appropriate payments below. Please note that your application will not be reviewed until all payments are submitted.
Please make appropriate selection before proceeding.*
prevnext( X )
AADH Initial Membership Application Fee & Membership Dues$210.00
Non-ADHA Member

AADH Initial Membership Application Fee & Membership Dues$150.00
ADHA Member

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Application Fees: