How to join the IADMFR

Last Name:

First Name(s):
Degree(s):
Title(s):
Occupation:
Nationality:
Date of Birth:
Permanent Address:
Street:
Zipcode:
City:
Country:
Phone:
Fax:
Email:

Please make payable to:
"International Association of Dentomaxillofacial Radiology."

US $65 per year or     US $150 for 3 years.
Payment:   Visa     MasterCard*    Amex   

 Once the fees are paid no refund is possible
 MEGLAKOR is the vendor that processes internet and credit card transactions for
the Association and MEGLAKOR not IADMFR will appear on the member’s credit card statement


Card#                       
Name Card Holder Exp.Date

* Visa and MasterCard users only: Number on reverse side of card (last 3 digits)

If you are member of a National Association of Dentomaxillofacial Radiology, please give
name of the association:

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