Membership Form

Contact us via this form

 

I want to become an*
Full Name*
Your email*
Address
Gender  Male    Female
Marital Status  Married    Unmarried
Ethnic Origin
Qualifications
College of Graduation
College of Post Graduation
GDC Number
Are you a member of any other body/association  Yes    No
If yes, Name of the Association
I consent to my personal data being collected and stored as per the Privacy Policy*.
I consent to my personal data being collected and stored for the purpose of marketing communications.

PAYMENT OPTIONS

Following are the payment options for IDA-UK Membership

  By Cheque

All cheques are to be made payable to 'INDIAN DENTAL ASSOCIATION - UK' to be posted to the following address.
CHARITY REGISTERED IN ENGLAND NUMBER - 1169659
SUITE 205, 28 A QUEENSWAY, BAYSWATER, LONDON W2 3RX.

  By Bank Transfer

INDIAN DENTAL ASSOCIATION-UK
Account Number: 38005068
Sort code : 30-65-41


Once your membership is approved we will get in touch with you. Thank you for your support.

Just drop an email at indiandentalassociationuk@gmail.com after filling in the form.