IDA-IUSD Student Membership Activation Form

First name *

Last name *

Cell phone number *

Your preferred email (required) *

Your hometown and state/country *

In which IUSD program are you enrolled? Limit 2000 Characters

When you are not attending dental school, what would we find you doing? Limit 2000 Characters

Yes, I would like to activate my membership in the Indiana Dental Association and receive occasional emails and texts from the IDA (You can unsubscribe anytime)