Student 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 Fee:
$10.00
Membership Dues:
$25.00
Submission Requirements Checklist:
Date of Application:
Today's Date
Name:
First Name
Last Name
Credentials:
Credentials
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SMS Number:
-
Area Code
Phone Number
Email Address:
Please avoid using an email address ending in .edu so our emails won't get blocked
Birthdate: (optional)
-
Month
-
Day
Year
Date
How did you hear about AADH?
Friend
Website
Colleague
Convention
Social media
Other
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
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Education:
*
Upload proof of academic standing within the Dental Hygiene Educational Program
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Professional Affiliations:
Are you a SADHA member?
Yes
No
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Non-refundable 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 be sure that both options are selected before proceeding.
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AADH Initial Membership Application Fee
$
10.00
AADH Initial Membership Dues
$
25.00
Quantity
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10
Total
$
0.00
Payment Methods
Debit or Credit Card
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make your payment.
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