Application Form

2025-2026 THE MAIMONIDES DENTAL SOCIETY APPLICATION
For further information contact: Dr. April Linder:  (215) 932-3758 (Maimonidesdental@gmail.com)

Name_______________________________________________Email___________________________
Address:____________________________________________________________________________
City_________________________________________________State__________________Zip:_____
Telephone Work_________________________________________Cell___________________________________

Dues:
–>Active Members: $475, includes all day meeting
–>Retired Members (If previously active member): $75 per dinner meeting, $295 all day meeting
–>Recent Dental School Graduates:
Year Graduated: 2023 ($425), 2024 ($375), 2025 ($325), includes all day meeting
–>Dental Students: 1 complimentary dinner meeting per year, $295 all day meeting
–>Team members (non-dentist): $75 for evening meeting, $295 for all day meeting

Please Return this Form with Payment to:
THE MAIMONIDES DENTAL SOCIETY
Attn: Dr. April Linder
4833 Bethesda Ave
Suite 302
Bethesda, MD 20814

How did you hear about us? ___________________________________________________________________________________
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