Membership Application Form - New DAPA Member

Thank you for considering membership to the Dental Assistants Professional Association.

Please make sure you have read all the information about membership here before continuing.

Membership Types

Please select the appropriate membership level below. You will have a chance to review your selection and the corresponding fees on the next page prior to being charged.

Membership *

Professional (Full) - $ 105.00

Platinum Membership - $ 160.00

Student (proof of enrollment required) - $ 30.00

Please renew my membership automatically.

Total Amount

Email Address *

My Personal Details

Formal Title

First Name *

Middle Name

Last Name *

Birth Date *

Years of Dental Experience

Street Address (Primary) *

Supplemental Address 1 (Primary)

City (Primary) *

State (Primary) *

Postal Code (Primary) *

Country (Primary) *

Phone-Mobile (Primary) *

Current Employer *

Job Title

Street Address (Work) *

Supplemental Address 1 (Work)

City (Work) *

State (Work) *

Postal Code (Work) *

Country (Work) *

The Dental Assistants Professional Association is an approved NSW Smart and Skilled* provider, and more information on this can be found at the smart and skilled website https://education.nsw.gov.au/skills-nsw
*'This training is subsidised by the NSW Government.'

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Membership Application Form - New DAPA Member