Member Registration

Fields marked with an * are required

Firm Information


Company Representative (Voting)


Alternate Representative


Fee Structure


The undersigned does hereby make application for membership in the Dental Industry Association of Canada. We agree to abide by the Articles of Incorporation and By-Laws of the Association, to pay all dues and assessments, and to offer our cooperation in the activities of the Association to further its objectives within the limits provided by the By-Laws.

The applicant hereby certifies that the applicant is now, and if this application is accepted, will continue to be, so long as the applicant is a member of the Association, in full compliance with all federal, provincial, municipal, local laws, statutes, regulations, directives, ordinances and, without limitation, all other legal requirements applicable to the regulation of the Dental Industry (“Governing Laws”).

For greater certainty Governing Laws include all legal requirements relating to the regulation and governing of the use of facilities, storage and sale of products and service offerings, and the packaging of products by members of the Association.