New member application

To the Board of Directors

I hereby apply for membership in the Hellenic Association of Endodontists. I declare that I agree with the mission of the Hellenic Association of Endodontists as stated in the article 2 of the Memorandum and that I fulfill all the requirements stated in the article 7 of the Memorandum.
Please accept my application.






Last Name:
First Name:
Son of:
Office Address:
Telephone: Mobile
Phone:
email:
website:
Dental School:
Year of Graduation:
Advanced Specialty Education Program in Endodontics:
Duration of Program: Year of
Graduation:
Academic Degrees:

If accepted into membership by the Committee of Directors, the hereby applicant is due to pay the subscription fee to the Association.

The subscription fee for the year 2014 is 100,00 €.

For the subscription payment, please use the Association’s Bank Account:

Piraeus Bank
Acc. No 5050-063397-887
IBAN GR58 0172 0500 0050 5006 3397 887
Please send the deposit receipt via email:  info@greekendodontists.gr