AAO WFO Membership Application |

AAO/WFO Membership Registration

1NAME

2MAIN/SCHOOL/TEACHING FACILITY

3CURRENT RESIDENCE

4EDUCATION

5CERTIFCATION/VERIFICATION/DECLARATION

Name*
First Middle Last
Email*
Date of Birth*
DD slash MM slash YYYY

dd/mm/yyyy
Country of Citizenship*
Country
Gender*
- Male
- Female
- Non-binary/third gender
- I use another term
- Prefer not to say
Choose a WFO Membership*
Product Name

Contact
Main Office/School/Teaching Facility

You must complete the information below (MAIN OFFICE/TEACHING FACILITY or HOME) for contact purposes.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Website
Fax

Current Residence
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mobile Phone*
Land-line Phone
Email*
I prefer to receive mail at this address
- Office
- Home
I prefer to receive email at this email address
- Work
- Personal

Education
Dental School Attended*
Degree*
Date of Completion*
DD slash MM slash YYYY

dd/mm/yyyy
Orthodontic School Attended*
Degree*
Date of Completion*
DD slash MM slash YYYY

If you are currently a student list your expected date of completion

Certification/Verification/Declaration
WFO Fellow Applicants
Name*
Print your name as you want it to appear on the certificate of fellowship
Organization*
National or regional orthodontic organization to which I belong
Country where organization located (must be affiliated organization of the WFO)*
Country where organization located (must be affiliated organization of the WFO)
WFO Student Applicants

I hereby certify that the applicant on this form is enrolled as a post-graduate orthodontic student at the stated institution at which I am employed
Name of dean, orthodontic department chair or program director*
Name of dean, orthodontic department chair or program director
Email Address*
Email for dean, orthodontic department chair, or program director
AAO Pledge

The American Association of Orthodontists (AAO) seeks to exemplify, enforce and promote the highest traditions in the practice of orthodontics. In making this application, I agree that the AAO may investigate my qualifications. I, therefore, pledge myself, as a condition of membership in the AAO, to live in strict accordance with all its principles, declarations and regulations, as presented in the Bylaws and the Principles of Ethics and Code of Professional Conduct of the AAO, which I have received and read.
WFO Oath

I swear under oath that the answers to all questions on this application are true and complete to the best of my knowledge and that I am qualified to be a WFO fellow or student member. I also understand and agree that the WFO may investigate my qualifications. I further waive the right to hold the WFO, its affiliates, executive committee, officers, members and employees responsible for any damage as a result of the denial of this application or any other action taken by the WFO. I hearby agree to comply with the WFO Charter, Bylaws and Policies should I be approved for WFO membership.
Signature*
Date
DD slash MM slash YYYY

AAO/WFO Membership Registration

Contact

Main Office/School/Teaching Facility

Current Residence

Education

Certification/Verification/Declaration

WFO Fellow Applicants

WFO Student Applicants

AAO Pledge

WFO Oath