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NOTE: Please provide at least one mobile or home number.
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I am a member of the ADA in another state.
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Which university did you attend?
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And in which year did you graduate?
Were you required to complete an ADC exam?
Enter your AHPRA Dental Board Registration Number
Enter the date your were first registered
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Insurance Company
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Please indicate if you are retired from dentistry?
Please indicate if you are studying for a post graduate qualification in Dentistry
Weekly hours worked in public practice
Weekly hours worked in private practice
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Have you currently or in the past had a statutory complaint upheld against you or have you had membership of this organisation, or similar organisation, refused or terminated?
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To your knowledge, has there been or is there now any claim or circumstance which has given rise to or may give rise to a claim against you in relation to a dental practice?
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The quote for your membership fee will be confirmed once your application is evaluated.

By submitting this online application to become a member of the Australian Dental Association (New South Wales Branch) Limited ACN 000 021 232 (Association) you agree as a member of the Association to be bound by its Constitution and By-Laws. You agree to uphold the professional and ethical obligations of membership at all times. You understand that membership also includes mandatory membership of the Australian Dental Association Inc. (Federal) and confirm that all information you have supplied is true and correct.

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Phone: (02) 8436 9900

Email: membership@adansw.com.au