Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors
3858‌ Cashill Blvd.,‌ Reno,‌ NV‌ ‌89509
Phone‌ 775-626-5008‌‌

New Associate Membership

2018 Associate Membership/Organizational Membership

ASTDD is an affiliate of the Association of State and Territorial Health Officials.
Membership status
Your account is not presently associated with a membership level which requires membership renewal.
You may now renew your 2018 ASTDD associate membership. To renew, please review your contact and billing information, update if necessary, and provide the required credit card information
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As an Organizational Member of ASTDD you are allotted up to four Associate Memberships for individuals within your organization. Please complete the contact information below for your organization as well as those individuals who you would like to make Associate Members.
Organizational Contact Information for the ASTDD Website Roster
Name - First, Last *
Degree(s)
Title
Company/Agency
Organization
*
Street *
*
City *
State/Territory *
Country *
Zip *
Phone *
Fax
Email *
This email is already assigned to a member in the database.
Associate Members
How many Associate Members would you like to register?
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Name - First, Last *
Degree(s)
Title
Company/Agency *
Street *
City *
State/Territory *
Country *
Zip *
Phone *
Fax
Email *
This email is already assigned to a member in the database.
Billing Information
Select this box if your billing information is the same
Organization *
Name - First, Last *
Street *
City *
State/Territory *
Country *
Zip *
Phone *
Payment Information
Amount Due{{billing.amount | currency:'$':2}}
Card Number
*
Expiration Date / *
Credit Card Code (CVV) *Where is my CVV code?
Agreement*I agree that I have read and comply with this website's Terms and Conditions
* This information is required in order to complete an online transaction.
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