2023-2024 CTDA Annual Membership Registration Form
Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
Would you like to join the Charleston Trident Dietetic Association? *
You must be an Academy member to join CTDA
Your state affiliate must be South Carolina. To change your affiliate, go to the Academy Member Payments tab of the eatright.org web page.
Academy Membership Number: *
You must be a member of the South Carolina Academy of Nutrition and Dietetics (SCAND).
Your state affiliate must be South Carolina. To change your affiliate, go to the Academy Member Payments tab of the eatright.org web page.
Please confirm that you are affiliated with SCAND: *
Employer:
Area of Practice:
Membership Type (select one): *
Note: For Student and Professional Memberships, State Affiliate must be SCAND.
  • Retired Membership - $10
  • Student Membership - $15
  • Professional Membership - $40
Please indicate below whether you are paying via Venmo or Cash/Check. At the end of this form, follow the link to pay via Venmo, Paypal, or CC.
Cash or check must be provided to CTDA board member in-person. Checks may also be mailed to our treasurer at the address below.

Jaclyn Savage
425 Cessna Ave
Charleston, SC 29407

Optional Donations:
  • Scholarship Donation - Your donation will help us support one of our local dietetic interns. Interns can be nominated by CTDA members. Scholarships are awarded at the Spring CEU Dinner.
  • Policy Day Donation - Your donation will help support CTDA members interested in attending the SCAND Legislative Day event in Columbia, SC to learn more about Public Policy and Advocacy for the Nutrition Profession.
Clear selection
Optional Donations - $
For donations, please indicate how much you would like to contribute.

If paying via cash or check, leave this blank.
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms