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  • Cosmetic Dentistry& Bio Mechanics

    Restore the youthful appearance with long lasting effects.

  • FacialAesthetic Treatments

    Create a more youthful, natural appearance, where patients look & feel better.

Membership Application

**Documents needed for application for new members:

  1. Fully completed personal details from (application form)
  2. Proof of aesthetic or anti-aging trainings attended locally or internationally.
  3. Shorten CV

Full or Candidate membership will be granted after evaluation and approval of the documents by the academic committee. The committee could ask for more details after evaluation of documents.

Membership fee should only be paid after approval of application by the academic committee.

  • Personal Details:

    First Name*
  • Title
    DP Number
  • ID Number*
    HPCSA Number
  • Email*
    Postal Code
  • Postal Address
  • Practice Address1*
    Practice Address2
  • Telephone Code*
    Telephone Number*
  • Fax Code
    Fax Number
  • Special Practice or Procedure Interest(s)
    • Please indicate the procedure that you perform

      • Cosmetic Dentistry
        Average amount of the procedures per month
        Peri orbital, maxillofacial areas
        Average amount of the procedures per month
      • Crowns, Veneers
        Dermal Fillers
      • Implants
        Gingival Fillers
      • Tooth Whitening
      • Anti-ageing Dentistry
        Botulinium Toxin
      • Orthodontics
      • Periodontic Contouring
      • Aesthetic or Anti-aging Medicine Tranings or certifications obtained in the previous year:
        CPD accredited (or CME) Aesthetic or Anti-aging Medicine Tranings attended:
        Amount of CPD points per event:
      • Any Malpractice/HPCSA cases against you:
         YES NO
      • If yes, provide details:

      • Membership Fee 2016
      • Cosmetic Dentistry & Facial Aesthetics Society
        Account number: 408 640 9907
        Branch: 632 005
      • Email: [javascript protected email address]
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