Membership

  • 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 access to quality education, including a searchable database of continuing education offerings throughout the U.S. and Canada;
  • Advocacy efforts to protect your profession within your state and in the nation's capital;
  • Subscriptions to the AGD's award-winning publications General Dentistry and AGD Impact;
  • Free patient education and appointment reminder service; and more!

If you have questions while completing the application, please contact the AGD Membership Services Center at 888.AGD.DENT (888.243.3368) or membership@agd.org.

If you prefer, you can download a paper application PDF and mail or fax it to the AGD. (For use by any applicant. Dues information on page 2)

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 Business Address Home Address

The location of your business or residency will determine your local constituency. To be included in the Find an AGD Dentist Web directory, your business address is required.

Preferred method of contact     

Business Address

Address
   
City
State
Zip
Country
Phone
Fax
Web site http://

Home Address

Address  
   
City  
State  
Zip  
Country  
Phone  

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