Life membership $ 40.00

Membership Form

Please fill the form below and proceed for payment :

Required fields are marked (*).
Title
First Name	*
Middle Initial
Last Name	*
Name on Credit Card	*
Registering for yourself or others?	* if registering for other then plz specify name.
Address	*
City	*
State	*
Zip	*
Phone	* e.g. (999-999-9999)
Fax	e.g. (999-999-9999)
E-mail	*
Lic. No.	*
	If you don't have a license number type 00000
Security Code*

Punjabi Dental Society invites you to join the society as a member. The membership is open to everyone affiliated with dental profession. As a member of Punjabi Dental Society you qualify for following benefits:

Discount on every continuing education seminar conducted by Punjabi Dental Society.
Discount on dental supplies, dental repairs, printing ,travel services, car rental, office
Book keeping ,Accounting , Payroll services, collection agency, dental office design & construction
These businesses have agreed to give benefits to PDS members. PDS takes no
responsibility for their product or services. You will conduct business with them at your own risk.
To place free advertisement on web site call 1-866-4-CALL-PDS.

Present your membership card to qualify for these benefits

PDS reserves the right to cancel membership at anytime