Required Documents The following documents are required to complete your membership application: Payment Receipt (according to membership category) Life Member: PKR 10,000 Regular Member: PKR 1,000 Student Member: PKR 300 Please transfer the membership fee to the following bank account: Account Title: Pakistan Dental Association Account Number: 02071010305335 IBAN: PK09ALFH0207001010305335 Bank: Bank Alfalah Recent Personal Photograph Maximum file size: 2 MB CNIC Maximum file size: 2 MB PMDC Registration Certificate Maximum file size: 2 MB Not required for student members Membership FormMember Type *Life Member (PKR 10,000)Regular Member (PKR 1000)Student Member (PKR 300)Upload Payment Receipt *Maximum One File of 2 MB.Drag and Drop (or) Choose FilesUpload Photo *Please upload your recent photograph in blue or white background. Maximum One File of 2 MB.Drag and Drop (or) Choose FilesFull NameFather NameGender *MaleFemalePrefer not to sayCNIC *0 / 13Upload CNIC *Maximum One File of 2 MB.Drag and Drop (or) Choose FilesPM&DC No. *Upload PM&DC Registration Certificate *Maximum One File of 2 MB.Drag and Drop (or) Choose FilesEmail Address (Primary) *Email Address (Alternate)Phone (WhatsApp) *Street Address *Apartment, suite, etcCity *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweCity BranchProvincial Chapter *Punjab ChapterSindh ChapterBaluchistan ChapterKhyber Pakhtunkhwa ChapterAzad Jammu and Kashmir ChapterGilgit-Baltistan ChapterFederal ChapterQualifications *Designation *Describe YourselfYour Brief ProfileClinic/ InstituteDeclaration & Undertaking *I confirm that the information provided is accurate and complete. I agree to comply with the Constitution, rules, and regulations of the Pakistan Dental Association (PDA) and accept to be bound by them. Submit FormPlease do not fill in this field.
