2022 Fellow Elect Checklist & Information

Fellow Elects only, complete before September 1, 2024

Make a Payment

To complete your status as a Fellow-Elect and reserve your place in the ceremony, please make your payment of US$650.00 on the Registration Page.
Nominate a Colleague

Please Nominate a Colleague whom you feel has made outstanding contributions to the dental profession, his or her community, church, or synagogue, or to the well being of mankind in general. They will be sent a nomination invitation package inviting them to be inducted in the Class of 2020.
Complete the form below

Provide your name as you want it to appear on your Certificate of Fellowship. Upload a Recent Photo. This will assist us in assuring that you receive the correct photos taken at the induction ceremony. Provide your Cap and Body Size. If you do not know your fitted Cap Size, measure the circumference of your head where a cap sits with tailors tape, string, or even dental floss. Provide the measurement in centimeters or inches. We will convert it.

Your Name on Certificate*

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Recent Photo*

Your Email Address*

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Height*

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Weight*

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Cap Size*

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Comment

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