Constituent

Individuals who have completed an accredited formal prosthodontic training program or are licensed as a prosthodontist by their governing body/licensing authority for dentistry. In countries with no specialty course in prosthodontics, those who hold membership in local or regional prosthodontic organizations as well as full-time senior teachers in prosthetic dentistry will qualify for constituent membership. Documents required to confirm certification as a prosthodontist, teacher, or prosthodontic organization member.

If you reside in a Lower Developed Country, you will receive a $100 discount on your membership dues.
View list of countries that qualify for the LDC discount.

Constituent members get online and hardcopy journal subscriptions as part of membership.
LDC Constituent members get online journal. Hard Copy journal offered at additional $125.

Membership Dues: $275.00

Honorific

First Name

Last Name

Job Title

Date of Birth

Other Organizational Memberships

Contact Information

This address will be displayed in the member directory.

Country

Address

City

State / Province
If you choose international/other, you can add your region into the city field, above.

Zip / Postal Code

Telephone Number (include country code)

Email Address

Affiliation Information

University / Institution / Affiliation / Private Practice

Department

Position / Title

Personal / Private Practice Website URL

Education Information

Licensed?
Y N

Licensed Date

License Authority

Certified?
Y N

Certified Date

Certificate Authority

Professor?
Y N

Professor at

Undergraduate School Attended

Undergraduate Degree Completed on

Graduate School Attended

Graduate Degree Completed on

Are you currently enrolled in a full time recognized Prosthodontic training program?
Y N

University / Program Attending

University / Program Department

University / Program Chairperson

Email address of University / Program Chairperson

University / Program Enrollment Date

University / Program Expected Graduation Date

Supporting Documentation

Documents required to confirm certification as a prosthodontist, teacher, or prosthodontic organization member.

References

How did you hear about the ICP?
A Member Referral
Colleague
ICP Meeting
ICP Web Site
ICP Webinar
International Journal of Prosthodontics (IJP)
Invitation
Journal Advertising (other than IJP)
Social Media
Other:

Membership Reference List one (1) ICP Constituent Member for reference

Reference First Name

Reference Last Name

Reference Email

Privacy Information

Do you consent to receive email communications from us, regarding your membership?
Y N

Show in member directories?
visible hidden

Who can view member details?
public members only administrators only

Membership Options

Years of Membership to Purchase

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