2026-2027 THE MAIMONIDES DENTAL SOCIETY APPLICATION
For further information contact: Dr. April Linder: (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: 2024 ($425), 2025 ($375), 2026 ($325), includes all day meeting
–>Dental Students: $75 for evening meeting, $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. Justin Tabatabai Please list any dietary restrictions/allegies
2440 M St., NW ____________________________
Suite 601 ____________________________
Washington, DC 20037
How did you hear about us? ___________________________________________________________________________________
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maimonidesdds 