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EAED Affiliate Application
Please fill out this form to start the procedure of becoming an Affiliate of the EAED.
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* Indicates required question
Title
*
Choose
Mr.
Ms.
Mrs.
Dr.
Prof.
CDT
MDT
E-Mail
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Contact Information
Street
*
Your answer
City
*
Your answer
ZIP Code
*
Your answer
Country
*
Your answer
Telephone
*
Your answer
Mobile Phone
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Education
Pre-Doctorate Dental Education
*
Your answer
Year of Graduation
*
Your answer
Postgraduate Dental Education
Your answer
Speciality
Your answer
Professional Career
Academic or Professional Degrees
Your answer
Memberships in Professional Organisations
Your answer
Professional Honors, Offices, Committee Chairmanships
Your answer
EAED Meetings
*Attend a minimum of two Spring Meetings as a guest (within a four-year period) to qualify.
EAED Meetings attended:
*
Milan 2017
Sorrento 2018
Munich 2019
Bordeaux 2022
Cannes 2023
Required
Files
Your application is only complete with the following additional documentation to be sent to the Secretariat (
info@eaed.org
) with the Subject "Affiliate Application [Full Name]"
• Current Curriculum Vitae
• Current Photo
• 3 Active Member Signatures (Form available here:
http://eaed.org/wp-content/uploads/2021/05/Sponsor-Letter-for-Active-Candidate.pdf
)
Optional:
• List of Publications
• List of Major Lectures Given
Submit
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