Membership Forms

apply or renew

Membership

Please complete the following form for both new member applications and renewals. Note that it takes 1 - 2 weeks for our volunteers to process membership applications. Note CDAA honorary Members…….. payment amount***

Name *

First

Last

Maiden Name

Email *

Confirm Email

Cell Phone *

Mailing Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Are you currently a DA student? *

Layout

AB Practice Registration # *

CDAA # (if known):

How did you hear about us? *

Facebook
Instagram
Other

Please select the category of membership you are paying for: *

Calgary / Alberta / Canadian DAA Tri-level Member Dues+ Professional Liability Insurance - $ 103.00
Calgary / Alberta / Canadian DAA member dues (No PLI included) - $ 85.00
Calgary / Alberta Member Dues (No PLI or Canadian Membership included) - $ 40.00
Calgary Student / Alberta /Canadian DAA student Dues (No PLI included) - $ 65.00
Calgary Student / Alberta Member Dues (No PLI or Canadian Membership included) - $ 20.00
Honorary Member (please contact membership coordinator for pricing) - $ 0.00

I agree that I have been advised that the CDAA cannot provide me with complete services unless this form is on file with all of the requested information provided? *

I accept that information provided to the CDAA by our members will only be used for association related business. Any information provided will be used in the reasonable and usual conduct of association business including but not limited to: Employment Registry services, Awards and Recognition, Newsletters, Board and Committee business, Continuing Education, Events Registration. Unless specifically notified by an individual member of specific information that is not to be used for a specific purpose, the member gives the CDAA permission to use any information on file for the reasonable and usual conduct of association related business? *

I agree to the use of the following information by the CDAA for the reasonable and usual purposes of conducting the business of the association. I understand that it is my responsibility to advise the CDAA directly of any change to this information when it occurs. I understand that failure to do so may result in loss of benefits or services relying on this information? *

How would you prefer to pay? *

Secure Credit Card
eTransfer

GET YOUR MEMBERSHIP CARD

Register today and take advantage of CDAA member benefits. Upon registration you will get your CDAA Membership Card and CDAA membership number. Your card will be required to access the benefits available through CDAA and AADA.

GET MEMBERSHIP TODAY

Membership Forms

apply or renew

Membership

Please complete the following form for both new member applications and renewals. Note that it takes 1 - 2 weeks for our volunteers to process membership applications. Note CDAA honorary Members…….. payment amount***

GET YOUR MEMBERSHIP CARD

Register today and take advantage of CDAA member benefits. Upon registration you will get your CDAA Membership Card and CDAA membership number. Your card will be required to access the benefits available through CDAA and AADA.

Dental Assistant Recognition Week

Fall Seminar Save the Date – Sept 23, 2023

Membership Forms

apply or renew

Membership

Please complete the following form for both new member applications and renewals. Note that it takes 1 - 2 weeks for our volunteers to process membership applications. *Note* CDAA honorary Members…….. payment amount***

GET YOUR MEMBERSHIP CARD

Register today and take advantage of CDAA member benefits. Upon registration you will get your CDAA Membership Card and CDAA membership number. Your card will be required to access the benefits available through CDAA and AADA.

Please complete the following form for both new member applications and renewals. Note that it takes 1 - 2 weeks for our volunteers to process membership applications. Note CDAA honorary Members…….. payment amount***