ICP :: International College of Prosthodontists

Member Overview / Summary
Contact Info Email Address needs to be updated:
Contact Info Mailing Address needs to be updated:
Contact Name:
Membership ID:
Contact Email Address:
Affiliation:
Membership Classification:
Current Amount Due:	$
Make a Donation:
Contact information made available on ICP website:

Member Classification
Member Classification applying for *
Affiliate (Annual Dues: $275, Processing Fee: $55 , Includes IJP: Yes) Affiliates are Dentists or scientists* who do not qualify as Constituent members but have demonstrated contributions to prosthodontics. Scientist is interpreted by the ICP as a clinical or basic scientist with graduate degree qualifications who has demonstrated a contribution to the specialty of prosthodontics. Affiliate Student (Annual Dues: $120 , Includes IJP: No)* Students who are enrolled full time in an accredited graduate prosthodontic program at a university. A signed letter from program director required. The IJP is not included with dues. Constituent (Annual Dues: $275, Processing Fee: $55 , Includes IJP: Yes) Constituent Members of the College shall be those individuals who have completed an accredited formal prosthodontic training program or are licensed as a prosthodontist by their governing body/licensing authority for dentistry. In countries with no specialty course in prosthodontics, full-time senior teachers in prosthetic dentistry may qualify for constituent membership. Documents required to confirm certification as a prosthodontist or teacher. Organization (Annual Dues: $0 , Includes IJP: No) Organizational Members are organizations devoted to the specialty of prosthodontics. Organizational Members may not vote in College business or elections and may not hold elective office.

Login Information
How did you hear about the ICP?
Username: *
Password: *
Confirm Password: *
Check the following box to make you information public on the ICP website (Find a Member).*

Contact Information
Title:
First Name/Given Name/Forename: *
Last/Surname/Family Name: *
Country: *
Address 1: *
Address 2:
Address 3:
Address 4:
City: *
State/Province/Region: *
Zip/Postal Code:
Telephone Number (include country code):
Email Address: *

Organization Information

Organization Name:

Acronym for Organization:

Organization's General/Public Email Address:

Organization's Website Address:

Does organization provide conferences for members?

Location of your next general meeting:

Website URL of your next general meeting:

Date of your next general meeting:

Open the calendar popup.

Organization is a: (Select all that apply)

National Organization:

International Organization:

Local/Provincial/State Organization:

Organization's membership include: (Select all that apply)

General Dentists:

Specialist Prosthodontists:

Other Specialist Groups:

Dental Hygienists:

Technologists:

Scientists:

Does organization provide certification or credentialing at any level? YES NO

Is organization certified or registered as a continuing education provider? YES NO

IJP Information. Complete this address for IJP delivery.
Mail Address
Same as Contact Information?
Country:
Address 1:
Address 2:
Address 3:
Address 4:
City:
State/Province/Region:
Zip/Postal Code:

Journal Request History
to change your mailing address on an existing order below, click 'Edit Address' which will load the address above. Then click 'Save Updated IJP Address'

Edit Address	Journal Year	Journal Purchased	Date Ordered	Last Edited	Address
No records to display.

Affiliation Information
University / Institution / Affiliation / Private Practice:
Department:
Position / Title:
Personal / Private Practice Website URL:

Education Information

Licensed?

Certified?

Professor?

Undergraduate School Attended:

Undergraduate Degree Completed on:

Open the calendar popup.

Graduate School Attended:

Graduate Degree Completed on:

Open the calendar popup.

Are you currently enrolled in a full time recognized Prosthodontic training program?

Other Information

Date of Birth

Open the calendar popup.

Other Organizational Memberships

Membership Reference List one (1) ICP Constituent Member for reference

First Name

Last Name

Email Address:

Supporting Documentation

After you click "Submit Application" and submit your initial payment, you will be prompted to upload any supporting documentation.

Supporting Documentation

Students: Please upload a document supporting status of current enrollment, signed by Program Director.
Constituent Members: Please upload supporting document of Prosthodontic Specialty License. If your country does not recognize the specialty of Prosthodontics, please provide the name of the local Prosthodontics organization of which you are a member.

Remember to press the Save Member button below

Select file to upload:

	File Name	Uploaded
Zero documents uploaded, use button above to upload

Member Photos

Member Photos are optional.

(Note: Photo file extension cannot contain UPPER CASE characters (e.g. on your computer, right click & rename yourfile.JPG to yourfile.jpg)

Remember to press the Save Member button below

Select photo to upload:

		Is Main Photo	Photo Name	Uploaded
Zero photos uploaded, use button above to upload

Member Registration Payments
NOTE: IJP subscription will begin 4-6 weeks after payment. Mailing of back issues no longer provided. Refer to internet on-line subscription to view back issues.

Receive Journal:

Pay next years dues now?

Membership Amount Owed *
(includes previous years and any late fees or processing fees)


1.
2.
2. Split to both funds
Enter Donation amount: $
Total amount of transaction: $

Credit Card Information

Card Number *

Card ID/CCV *

(3 or 4 digit number on back of card)

Card Expires *

Name on Card *

First: Last:

Processing... Please do not navigate away from this page or close your browser while payment is processing, this process can take up to one minute.

Please do not navigate away from this page or close your browser while payment is processing, this process can take up to one minute.

(Administrative Use Only!)

Username:

Password:

Payment History

Amount Paid	Date
No records to display.

Donation History

Donation Amount	Type	Date
No records to display.

Make a Donation
The ICP appreciates your generosity and support for the initiatives listed below.
Click on each Program for additional detail.
Your ICP Donations can be applied to a specific program or shared. Choose your favorite:


1. YPE Workshops for Early Career Prosthodontic Educators
2. Research and Education Grant Program
2. Split to both funds

Credit Card Information

Donation Amount

Card Number

Card ID/CCV

(3 or 4 digit number on back of card)

Card Expires

Name on Card

First: Last:

(Administrative Use Only!)

Username:

Password:

Member Classification Change

If you are a Student and request change to Affiliate, press “Request Change” button for Affiliate
If you are a Student or Affiliate and request change to Constituent, 1st: fill out comment box below and provide information, then 2nd: press "Request Change" button to Constituent Member:
Are you a full time senior teacher in prosthetic dentistry? Are you licensed or certified as a prosthodontist?
Undergraduate school attended and degree? Graduate school attended, degree and date you received your degree?
If you are a Constituent member and request Life Member, fill out comment box regarding criteria posted under Life Member definition, then press "Request Change" button for Life Member.

The Membership Committee will review your request for consideration and respond shortly.

Comments:

	Classification
	Affiliate (Annual Dues: $275, Processing Fee: $55 , Includes IJP: Yes) Affiliates are Dentists or scientists* who do not qualify as Constituent members but have demonstrated contributions to prosthodontics. *Scientist is interpreted by the ICP as a clinical or basic scientist with graduate degree qualifications who has demonstrated a contribution to the specialty of prosthodontics.
	Constituent (Annual Dues: $275, Processing Fee: $55 , Includes IJP: Yes) Constituent Members of the College shall be those individuals who have completed an accredited formal prosthodontic training program or are licensed as a prosthodontist by their governing body/licensing authority for dentistry. In countries with no specialty course in prosthodontics, full-time senior teachers in prosthetic dentistry may qualify for constituent membership. Documents required to confirm certification as a prosthodontist or teacher.
	Invited Speaker (Annual Dues: $0 , Includes IJP: No) Constituent Members of the College shall be those individuals who have completed an accredited formal prosthodontic training program or are licensed as a prosthodontist by their governing body/licensing authority for dentistry. In countries with no specialty course in prosthodontics, full-time senior teachers in prosthetic dentistry may qualify for constituent membership. Documents required to confirm certification as a prosthodontist or teacher.
	Life Member (Annual Dues: $0 , Includes IJP: No) Life Members of the College shall be those Constituent Members who apply for Life Membership, or are proposed by the Board of Councilors, and who have held memberships in the College for at least ten consecutive years immediately prior to applying or being proposed and who have attained the age of 65, or who because of illness, are retiring from active participation in prosthodontics and dentistry in general. Life Members may vote in College business or elections but may not hold elective office.
	Test Payment (Annual Dues: $1 , Includes IJP: No) Test Payment

Members Only... link to thumbnail titles below to view information. (pop-up blockers in your browser must be disabled for this website)