MemApp08:Layout 1.qxd - IADR/AADR

International Association for Dental Research
2008 Application for Membership
1619 Duke Street, Alexandria, VA 22314-3406, USA
+1.703.548.0066 • FAX +1.703.548.1883
E-mail: research@iadr.org • www.dentalresearch.org
Send Payment and Application to:
IADR
PO Box 75537
Baltimore, MD 21275-5537, USA
FAX +1.703.548.1883
FIRST NAME
LAST/FAMILY NAME
DEPARTMENT
TITLE
INSTITUTION/COMPANY
ADDRESS
CITY STATE/PROVINCE ZIP/POSTAL CODE COUNTRY
BUSINESS TELEPHONE
FAX
HOME TELEPHONE
E-MAIL
Optional: Gender: ❏ male ❏ female Date of Birth: __________________
STEP 1: REQUIRED
IADR MEMBERSHIP
Student
Dues
Member*
IADR Membership (Includes access to the ❑ $40.00
Journal of Dental Research online-only) ❑ $22.00 ❑ $50.00
❑ $80.00
STEP 2: REQUIRED
DIVISION/SECTION MEMBERSHIP
Dues
You must pick a Division/Section based on your country of residence. Student Member
❑ American Association for Dental Research (AADR) ❑ $17.00 ❑ $95.00
❑ Argentine Division ❑ $0 ❑ $0
❑ Australian & New Zealand Division ❑ $5.00 ❑ $55.00
❑ Brazilian Division ❑ $0 ❑ $0
❑ British Society for Dental Research ❑ $10.00 ❑ $35.00
❑ Canadian Association for Dental Research ❑ $10.00 ❑ $40.00
❑ Chilean Division ❑ $0 ❑ $20.00
❑ Chinese Division ❑ $0 ❑ $0
❑ Continental European Division ❑ $15.00 ❑ $30.00
❑ East & Southern African Division ❑ $0 ❑ $0
❑ Egyptian Division ❑ $0 ❑ $0
❑ Irish Division ❑ $0 ❑ $15.00
❑ Israeli Division ❑ $0 ❑ $0
❑ Japanese Association for Dental Research ❑ $10.00 ❑ $50.00
❑ Korean Division ❑ $0 ❑ $0
❑ Kuwaiti Division ❑ $0 ❑ $0
❑ Mexican Division ❑ $10.00 ❑ $25.00
❑ Nigerian Division ❑ $0 ❑ $0
❑ Scandinavian Division (Member category includes subscription to European Journal of Oral Sciences.) ❑ $15.00 ❑ $70.00
❑ South African Division ❑ $0 ❑ $0
❑ Southeast Asian Division ❑ $0 ❑ $0
❑ Venezuelan Division ❑ $10.00 ❑ $10.00
❑ Colombian Section ❑ $0 ❑ $22.00
❑ Costa Rican Section ❑ $0 ❑ $0
❑ Indian Section ❑ $0 ❑ $0
❑ Iranian Section ❑ $10.00 ❑ $20.00
❑ Jordanian Section ❑ $0 ❑ $0
❑ Mongolian Section ❑ $0 ❑ $0
❑ Panamanian Section ❑ $0 ❑ $0
❑ Peruvian Section ❑ $10.00 ❑ $10.00
❑ Russian Section ❑ $0 ❑ $0
❑ Saudi Arabian Section ❑ $0 ❑ $20.00
❑ Sudanese Section ❑ $0 ❑ $10.00
❑ Uruguayan Section ❑$0 ❑ $0
STEP 3: JOURNAL OF DENTAL RESEARCH
Student
Rates
Member
Print edition of the Journal of Dental Research (Includes shipping and handling) ❑ $53.00 ❑ $73.00
* See final page
to determine
your World Bank
classification.

STEP 4: IADR SCIENTIFIC GROUP/NETWORK MEMBERSHIP—Please check those which you wish to join and
include accompanying dues as noted. Student members may join up to 3 Scientific Groups with no additional dues required.
❑ Behavioral, Epidemiologic & Health
Services Research ($15)
❑ Cariology Research* ($4, $4, $15)
❑ Craniofacial Biology ($20)
❑ Dental Anesthesiology Research ($14)
❑ Dental Materials ($16)
❑ Diagnostic Sciences* ($4, $8, $17)
❑ Education Research* ($5, $5, $25)
❑ Evidence-based Dentistry Network* ($6, $10, $15)
❑ Geriatric Oral Research ($65)
❑ International RDC/TMD
Consortium Network ($25)
❑ Implantology Research ($15)
❑ Microbiology/Immunology ($20)
❑ Mineralized Tissue ($20)
❑ Neuroscience ($16)
❑ Nutrition Research ($15)
❑ Oral & Maxillofacial Surgery ($10)
❑ Oral Health Research ($10)
❑ Oral Medicine & Pathology ($25)
❑ Periodontal Research ($14)
❑ Pharmacology/Therapeutics/Toxicology ($20)
❑ Prosthodontics ($18)
❑ Pulp Biology & Regeneration ($15)
❑ Salivary Research ($19)
* Scientific Group/Network Dues are based on World Bank
Classification.
BRITISH DIVISION SCIENTIFIC GROUP MEMBERSHIP—Please check those which you wish to join and include accompanying
dues as noted. Student members may join up to 3 Scientific Groups with no additional dues required.
❑ Behavioral Science ($8)
❑ Dental Materials ($8)
❑ Implantology ($8)
❑ Microbiology & Immunology ($8)
❑ Mineralized Tissue ($8)
❑ Oral Medicine & Pathology ($8)
❑ Periodontal Research ($8)
STEP 5: TOTAL SELECTED ITEMS
STEP 6: PAYMENT OPTIONS
DUES & FEES
IADR membership is based on a calendar year (January 1-December 31). During the months of July and August, you may pay half the
annual dues. If you join from September through December, your membership and related items will be activated the following January.
IADR Dues (includes Journal of Dental Research online-only). REQUIRED $
Division/Section Dues REQUIRED $
Optional Print Journal Subscription $
IADR Scientific Groups (Students may join up to 3 at no cost.) $
British Division Scientific Groups (Students may join up to 3 at no cost.) $
TOTAL $
Check Total Enclosed $_____________ Make check payable to IADR in U.S. dollars. Check must be drawn on U.S. bank.
❑ Credit Card ❑ Visa ❑ MasterCard ❑ American Express Source Code: WEB
AMOUNT OF CHARGE
CARD ID NO. (the small number printed on the front or back of your credit card)
CARD NUMBER
EXP. DATE
PRINT NAME OF CARDHOLDER
SIGNATURE
BILLING ADDRESS
AUTOMATIC CREDIT CARD PROCESSING
❑ YES, please renew my dues AUTOMATICALLY in 2009 and subsequent years, using the credit card above. (Note: all dues, subscriptions,
groups and contributions that you chose this year will be charged in future years as well.)
❑ NO, please DO NOT renew my dues automatically in future years; please charge my credit card for 2008 ONLY and send me an invoice for
2009 and subsequent year.
OPTIONAL SPONSOR
NAME (PRINT OR TYPE)
IADR ID NO.
ELIGIBILITY FOR STUDENT MEMBERSHIP — REQUIRED
I understand that my eligibility for special student membership fees is based on my full-time enrollment in the educational course indicated
below. Student Membership is limited to 8 years, or completion of studies, whichever comes first, at which time Member category dues will be
assessed.
Enrollment Attested
SIGNATURE OF DEAN OR FACULTY ADVISOR
College and University Degrees (Please include dates and present level.)
NAME AND TITLE (PLEASE PRINT OR TYPE)
A. UNDERGRADUATE
B. GRADUATE
The expected completion date of my educational course or program is: (month/year) __________ /__________

World Bank
2008 IADR
Country Country Classification MemberDues
Afghanistan Low income $ 40.00
Albania Lower middle income $ 40.00
Algeria Lower middle income $ 40.00
American Samoa Upper middle income $ 50.00
Andorra High income $ 80.00
Angola Lower middle income $ 40.00
Antigua and Barbuda High income $ 80.00
Argentina Upper middle income $ 50.00
Armenia Lower middle income $ 40.00
Aruba High income $ 80.00
Australia High income $ 80.00
Austria High income $ 80.00
Azerbaijan Lower middle income $ 40.00
Bahamas, The High income $ 80.00
Bahrain High income $ 80.00
Bangladesh Low income $ 40.00
Barbados Lower middle income $ 40.00
Belarus Lower middle income $ 40.00
Belgium High income $ 80.00
Belize Upper middle income $ 50.00
Benin Low income $ 40.00
Bermuda High income $ 80.00
Bhutan Low income $ 40.00
Bolivia Lower middle income $ 40.00
Bosnia and Herzegovina Lower middle income $ 40.00
Botswana Upper middle income $ 50.00
Brazil Upper middle income $ 50.00
Brunei Darussalam High income $ 80.00
Bulgaria Upper middle income $ 50.00
Burkina Faso Low income $ 40.00
Burundi Low income $ 40.00
Cambodia Low income $ 40.00
Cameroon Lower middle income $ 40.00
Canada High income $ 80.00
Cape Verde Lower middle income $ 40.00
Cayman Islands High income $ 80.00
Central African Republic Low income $ 40.00
Chad Low income $ 40.00
Channel Islands High income $ 80.00
Chile Upper middle income $ 50.00
China Lower middle income $ 40.00
Colombia Lower middle income $ 40.00
Comoros Low income $ 40.00
Congo, Dem. Rep. Low income $ 40.00
Congo, Rep. Lower middle income $ 40.00
Costa Rica Upper middle income $ 50.00
Côte d'Ivoire Low income $ 40.00
Croatia Upper middle income $ 50.00
Cuba Lower middle income $ 40.00
Cyprus High income $ 80.00
Czech Republic Lower middle income $ 40.00
Denmark High income $ 80.00
Djibouti Lower middle income $ 40.00
Dominica Upper middle income $ 50.00
Dominican Republic Lower middle income $ 40.00
Ecuador Lower middle income $ 40.00
Egypt, Arab Rep. Lower middle income $ 40.00
El Salvador Lower middle income $ 40.00
Equatorial Guinea Upper middle income $ 50.00
Eritrea Low income $ 40.00
Estonia Lower middle income $ 40.00
Ethiopia Low income $ 40.00
Faeroe Islands High income $ 80.00
Fiji Lower middle income $ 40.00
Finland High income $ 80.00
France High income $ 80.00
French Polynesia High income $ 80.00
Gabon Upper middle income $ 50.00
Gambia, The Low income $ 40.00
Georgia Lower middle income $ 40.00
World Bank
2008 IADR
Country Country Classification MemberDues
Germany High income $ 80.00
Ghana Low income $ 40.00
Greece High income $ 80.00
Greenland High income $ 80.00
Grenada Upper middle income $ 50.00
Guam High income $ 80.00
Guatemala Lower middle income $ 40.00
Guinea Low income $ 40.00
Guinea-Bissau Low income $ 40.00
Guyana Lower middle income $ 40.00
Haiti Low income $ 40.00
Honduras Lower middle income $ 40.00
Hong Kong, China High income $ 80.00
Hungary Upper middle income $ 50.00
Iceland High income $ 80.00
India Low income $ 40.00
Indonesia Lower middle income $ 40.00
Iran, Islamic Rep. Lower middle income $ 40.00
Iraq Lower middle income $ 40.00
Ireland High income $ 80.00
Isle of Man High income $ 80.00
Israel High income $ 80.00
Italy High income $ 80.00
Jamaica Lower middle income $ 40.00
Japan High income $ 80.00
Jordan Lower middle income $ 40.00
Kazakhstan Upper middle income $ 50.00
Kenya Low income $ 40.00
Kiribati Lower middle income $ 40.00
Korea, Dem. Rep. Low income $ 40.00
Korea, Rep. High income $ 80.00
Kuwait High income $ 80.00
Kyrgyz Republic Low income $ 40.00
Lao PDR Low income $ 40.00
Latvia Upper middle income $ 50.00
Lebanon Upper middle income $ 50.00
Lesotho Lower middle income $ 40.00
Liberia Low income $ 40.00
Libya Upper middle income $ 50.00
Liechtenstein High income $ 80.00
Lithuania Upper middle income $ 50.00
Luxembourg High income $ 80.00
Macao, China High income $ 80.00
Macedonia, FYR Lower middle income $ 40.00
Madagascar Low income $ 40.00
Malawi Low income $ 40.00
Malaysia Upper middle income $ 50.00
Maldives Lower middle income $ 40.00
Mali Low income $ 40.00
Malta High income $ 80.00
Marshall Islands Lower middle income $ 40.00
Mauritania Low income $ 40.00
Mauritius Upper middle income $ 50.00
Mayotte Upper middle income $ 50.00
Mexico Upper middle income $ 50.00
Micronesia, Fed. Sts. Lower middle income $ 40.00
Moldova Lower middle income $ 40.00
Monaco High income $ 80.00
Mongolia Low income $ 40.00
Montenegro Upper middle income $ 50.00
Morocco Lower middle income $ 40.00
Mozambique Low income $ 40.00
Myanmar Low income $ 40.00
Namibia Lower middle income $ 40.00
Nepal Low income $ 40.00
Netherlands High income $ 80.00
Netherlands Antilles High income $ 80.00
New Caledonia High income $ 80.00
New Zealand High income $ 80.00
Nicaragua Lower middle income $ 40.00
World Bank
2008 IADR
Country Country Classification MemberDues
Niger Low income $ 40.00
Nigeria Low income $ 40.00
Northern Mariana Islands Upper middle income $ 50.00
Norway High income $ 80.00
Oman Upper middle income $ 50.00
Pakistan Low income $ 40.00
Palau Upper middle income $ 50.00
Panama Upper middle income $ 50.00
Papua New Guinea Low income $ 40.00
Paraguay Lower middle income $ 40.00
Peru Lower middle income $ 40.00
Philippines Lower middle income $ 40.00
Poland Upper middle income $ 50.00
Portugal High income $ 80.00
Puerto Rico High income $ 80.00
Qatar High income $ 80.00
Romania Upper middle income $ 50.00
Russian Federation Upper middle income $ 50.00
Rwanda Low income $ 40.00
Samoa Lower middle income $ 40.00
San Marino High income $ 80.00
São Tomé and Principe Low income $ 40.00
Saudi Arabia High income $ 80.00
Senegal Low income $ 40.00
Serbia Upper middle income $ 50.00
Seychelles Upper middle income $ 50.00
Sierra Leone Low income $ 40.00
Singapore High income $ 80.00
Slovak Republic Upper middle income $ 50.00
Slovenia High income $ 80.00
Solomon Islands Low income $ 40.00
Somalia Low income $ 40.00
South Africa Upper middle income $ 50.00
Spain High income $ 80.00
Sri Lanka Lower middle income $ 40.00
St. Kitts and Nevis Upper middle income $ 50.00
St. Lucia Upper middle income $ 50.00
St. Vincent and the Grenadines Upper middle income $ 50.00
Sudan Low income $ 40.00
Suriname Lower middle income $ 40.00
Swaziland Lower middle income $ 40.00
Sweden High income $ 80.00
Switzerland High income $ 80.00
Syrian Arab Republic Lower middle income $ 40.00
Tajikistan Low income $ 40.00
Tanzania Low income $ 40.00
Thailand Lower middle income $ 40.00
Timor-Leste Low income $ 40.00
Togo Low income $ 40.00
Tonga Lower middle income $ 40.00
Trinidad and Tobago Lower middle income $ 40.00
Tunisia Lower middle income $ 40.00
Turkey Upper middle income $ 50.00
Turkmenistan Lower middle income $ 40.00
Uganda Low income $ 40.00
Ukraine Lower middle income $ 40.00
United Arab Emirates High income $ 80.00
United Kingdom High income $ 80.00
United States High income $ 80.00
Uruguay Upper middle income $ 50.00
Uzbekistan Low income $ 40.00
Vanuatu Lower middle income $ 40.00
Venezuela, RB Upper middle income $ 50.00
Vietnam Low income $ 40.00
Virgin Islands (U.S.) High income $ 80.00
West Bank and Gaza Lower middle income $ 40.00
Yemen, Rep. Low income $ 40.00
Zambia Low income $ 40.00
Zimbabwe Low income $ 40.00