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Washington State Society of Periodontists
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Washington State Society of Periodontists
Membership Application
We would like to encourage all the Washington State Periodontists to support the society by becoming a member.
Application for membership (please type or print clearly)
Date:________________________
Name:_________________________________________________________________________
Office address: _________________________________________________________________
Office phone: ___________________________ Other phone:___________________________
Fax: ____________________________Email: ______________________________________
Membership Dues & 4 meetings ( $40.00 Savings!)$300.00
Dues Only $160.00
New Graduate Dues $ 80.00
Retired Member Dues $ 80.00
Current Student NO CHARGE
Each individual meeting $ 45.00 if paid separately for members and $ 28 for students.
Click here to download a PDF Application Form.
Return completed form with check payable to the WSSP, to the following address:
Washington State Society of Periodontists
21807 76th Ave. W.
Edmonds, WA 98026
Attn: Dr. Jung Song
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