Member Application Form
    Fill out each tab below, clicking [Submit Information] when completed, then click [Submit Application].

Member Overview / Summary
Contact Info Email Address needs to be updated:
Contact Info Mailing Address needs to be updated:
Contact Name:
Membership ID:
Contact Email Address:
Affiliation:
Membership Classification:
Journal Subscription:
Link to Journal tab for instructions on ordering hard-copy subscription.
Current Amount Due: $0        
Contact information made available on ADM website:
Join the ADM: ADM Membership Fees – select one of the following Fees if you are applying for ADM membership.
After completing a page, click Submit Information button to go to next page.
  • Student -with no PhD (Annual Dues: $40)
    Students are individuals with an interest in dental materials research and currently enrolled in an education program. Students must provide a signed confirmation letter of student status from either a sponsoring member or their learning institute, and complete the Education tab with expected graduation date. NOTE: Individuals who already hold a PhD degree are not eligible for Student Membership. Please apply as a Regular Member or First Year New Member
  • Post-Doctoral Member (Annual Dues: $55)
    Post-Doctoral Members hold a postdoctoral research position not to exceed 4 years in duration. Only postdoctoral researchers are eligible for this membership category and for a maximum of four years. Individuals who hold or have held a more senior academic role or faculty position for any length of time are not eligible for this category and should apply as Regular Members. Verification document attesting the postdoctoral role will be required at the time of application and can be provided by the section supervisor, Department Chair or Dean of the applicant’s institution.
  • First Year New Member (Annual Dues: $74)
    (first year cost)- Active membership is $149/year and begins after new member status, ending this calendar year (December). Select this option if this is your first time applying for ADM membership.
  • Regular Member (Annual Dues: $149)
    Active membership is $149/year and begins after new member status, ending this calendar year (December). Select this option if you have previously been a member of the ADM or you are an inactive member reactivating your membership.
  • Corporate (Annual Dues: $2000)
    Corporate Membership shall be recognized as a special membership status for business corporations. Corporate members will receive a complimentary subscription to Dental Materials (the journal) for the membership year. Corporate member names and corporate logos will appear in each issue of Dental Materials (the journal) throughout the membership year in acknowledgment of their member status. Corporate membership requires payment of annual dues.
All memberships include an On-Line internet subscription to the Dental Materials journal. Hardcopy subscriptions are optional and can be ordered on the Payment tab.

For check payment, download this pdf (click here) to apply via email, fax or mail to:
ADM
4425 Cass Street, Suite A
San Diego, CA 92109
Phone: +1 (858) 272-1018
Fax: +1 (858) 272-7687
Email: admin@academydentalmaterials.org

Please note that all transactions are non-refundable. Delivery of accessible membership privileges is provided electronically upon successful receipt of payment. Membership dues are on a calendar year basis for all membership categories. Annual membership will only be activated upon receipt of payment.
Member / Contact Information
First Name/Given Name/Forename:
Last/Surname/Family Name:
Country:
Address 1:
Address 2:
City:
State/Province/Region:
Zip/Postal Code:
Telephone Number (include country code):
Email Address:

Check box to include your information on public ADM website (Find a member)   
Login Information
How did you hear about the ADM?
Username:
Password:
Confirm Password:
Journal of Dental Materials – New applicants and members can only order the hard copy journal subscription when either joining or renewing their annual membership.

On-Line access to DENTAL MATERIALS is accessible to current members by clicking the Journal ICON link below after payment. A hard copy subscription is also available to all Membership types (except students) by choosing the Journal option on Payment Page tab. Emeritus members will have online access and a hard copy subscription if they elect to purchase the hard copy.

Hard copy - $26
You will elect to pay for the journal on the "Payment" tab.
Complete the Mailing Address fields below for hard copy delivery of Dental Materials. Subscription is for 1 calendar year. All journals will be sent for the current calendar year. Subscription is included with future ADM membership payment, unless member “unchecks” Hard copy box on the payment page.

Mailing Address
Same as Contact Information?
Country:
Address 1:
Address 2:
City:
State/Province/Region:
Zip/Postal Code:
Hard Copy Journal Request History
to change your mailing address on an existing order below, click 'Edit Address' which will load the address boxes above. Type information in Mailing Address boxes for your new mailing address. Then click 'Save Updated Journal Address'
Education Information
Title(s):
Other:
Licensed?
Certified?
Professor?
Specialist Registration:
Undergraduate School Attended:
Undergraduate Degree Completed:
Graduate School(s): Include graduate schools attended, degress and dates completed:
Are you currently a Student in an accredited program?
Program Director/Advisor:
Program Director/Advisor Phone Number or Email Address:
If you are a Student, what is your projected Graduation Date?
I do not have a PhD title
I am enrolled in a Masters, PhD or dental degree program
 
Affiliation Information (type N/A for any fields that are not applicable)
University / Institution / Affiliation / Private Practice:
Department:
Position / Title:
Personal / Private Practice Website URL:
Other Information (Optional)
Date of Birth: / /
Other Organizational Memberships:
Publications: Publications: List authors, article title, publication name and published date.
Example: Fitzpatrick BJ, Brockhurst P, Gullotta E. Determination of gold alloy loss during the production of cast dental restorations. USAn Dent Journal; Accepted for publication January 1998
Member Photos


(Note): Photo upload works best if your photo name does not contain any spaces or "special keyboard characters", please try to name with only English alphabet or numbers.


Select photo to upload:  

  Is Main PhotoPhoto NameUploaded
No records to display.
Member Registration Payments

           


Credit Card Information
Total Amount Owed
(includes any late fees and/or processing fees)
$0
Breakdown of Fees
Card Type
Card Number
Card ID/CCV (3 or 4 digit number on back of card)
Card Expires
Name on Card * First: Last:
Please do not navigate away from this page or close your browser while payment is processing, this process can take up to one minute.


(Administrative Use Only!)
Username:
Password:
Payment History
Annual dues payment history will commence in the calendar year 2013

Amount PaidDate
No records to display.


Conference Payment History
Amount PaidDate
No records to display.
Donation History
Donation AmountDate
No records to display.

Make a Donation
Credit Card Information
Donation Amount $
Card Type
Card Number
Card ID/CCV (3 or 4 digit number on back of card)
Card Expires
Billing Address:
City:
State/Province/Region:
Zip/Postal Code:
 
please allow time to process, process can take up to a minute



(Administrative Use Only!)
Username:
Password:
Member Classification Change
  • If you are a Student and request change to Regular Member, submit “Request Change” for Regular Member
  • If you are a Regular Member and request a change to Fellow, click the link for FELLOW for instructions for application and submit “Request Change” for Fellow Member.
  • If you are a Regular Member or Fellow Member and request a change to Emeritus, confirm your qualifications as described and press the button “Request Change” for Emeritus below.
The Membership Committee will review your request for consideration. Post any comments in the comment box below that will assist your administration office with your request for change of membership classification.

Comments:
 Classification
Student -with no PhD (Annual Dues: $40 , Includes: on-line journal)
Students are individuals with an interest in dental materials research and currently enrolled in an education program. Students must provide a signed confirmation letter of student status from either a sponsoring member or their learning institute, and complete the Education tab with expected graduation date. NOTE: Individuals who already hold a PhD degree are not eligible for Student Membership. Please apply as a Regular Member or First Year New Member
Post-Doctoral Member (Annual Dues: $55 , Includes: on-line journal)
Post-Doctoral Members hold a postdoctoral research position not to exceed 4 years in duration. Only postdoctoral researchers are eligible for this membership category and for a maximum of four years. Individuals who hold or have held a more senior academic role or faculty position for any length of time are not eligible for this category and should apply as Regular Members. Verification document attesting the postdoctoral role will be required at the time of application and can be provided by the section supervisor, Department Chair or Dean of the applicant’s institution.
Fellow (Annual Dues: $149 , Includes: on-line journal)
Fellowships are approved by the Credentials Committee according to the following guidelines:
  1. Achievement of advanced degrees: at least a master's degree and preferably a Ph.D., Odont Dr., or equivalent degree;
  2. Evidence of contribution: publication of at least ten (10), peer-reviewed, scientific articles in refereed journals, of which the candidate should be first author on one-half of the articles; and
  3. Longevity of commitment to the field: at least five (5) years of leadership through research, training, service and/or education beyond formal education.
  4. Normally at least Five (5) years of membership in the Academy of Dental Materials
Candidates for Fellowship should submit a curriculum vitae and letters of recommendation from a minimum of two Fellows of the Academy.
Regular Member (Annual Dues: $149 , Includes: on-line journal)
Active membership is $149/year and begins after new member status, ending this calendar year (December). Select this option if you have previously been a member of the ADM or you are an inactive member reactivating your membership.
Corporate (Annual Dues: $2000 , Includes: on-line journal)
Corporate Membership shall be recognized as a special membership status for business corporations. Corporate members will receive a complimentary subscription to Dental Materials (the journal) for the membership year. Corporate member names and corporate logos will appear in each issue of Dental Materials (the journal) throughout the membership year in acknowledgment of their member status. Corporate membership requires payment of annual dues.
Emeritus (Annual Dues: $0, without any journal subscription )
Emeritus Members are those individuals who have contributed to the field of dental materials and have retired from their professional position. They must have been Active Members or Fellows prior to achieving Emeritus status. An individual must apply in writing to the Secretary or President for Emeritus status. The Board of Directors will vote on awarding the Emeritus membership. An Emeritus Member will pay no dues, but would be assessed a member's subscription rate for the journal should he/she decide to continue the subscription. All other rights and privileges of Active Membership would be maintained.
Member Resources...
Members must be current with annual dues to link to ICONS.

Any "pop-up blocker" also has to be turned off To load these Members Only links.
Members Only... link to thumbnail titles below to view information



ADM - ACADEMY OF DENTAL MATERIALS        4425 Cass Street, Suite A   San Diego CA 92109, USA        P:  +1 (858) 272-1018   E: admin@academydentalmaterials.org