Membership Application Form - BDIA

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Become a Member

Membership Application Form

Complete the application form and become part of the BDIA community.

Your Details

First Name *

Last Name

Your Position *

Email Address *

Telephone Number

Principal Details

Principal First Name

Principal Last Name

Principle Email Address

Principal Telephone

Company Details

Registered Company Name

Trading Name

Company Registration Number *

Legal Status of the Business *

Company Founded Date *

Dental Business Commenced in UK Date *

Is there a recognised quality management system in place? For example, ISO9001 or similar *YesNo

If yes please provide details

Dental Turnover *

Do you have Audited Accounts? *YesNo

Company Address *

Company Telephone *

Company Email *

Company Website

Membership Details

Choose Your Membership Type *

a

Tell us why you are applying for a BDIA Membership *

Please Provide a Summary of your company’s activities, products & services *

Type of Business *

Computer ServicesDental DealerExporterImporterFinancial ServicesLegalManufacturerMarketingWholesaler

Other Details

Staff Training

Do all staff receive induction training? *YesNo

Will you be registering all relevant staff on the BDIA Certificate: Introduction to Dentistry? *YesNo

If not, is there an equivalent training programme in place? *YesNo

Associated Companies

Do you have any associated companies?* *YesNo

If yes, would you like your associated companies to hold group membership?YesNo

If yes please list the companies below

Supporting Documentation

Please upload your last 3 years' accounts. If audited please upload your last 3 years' audited accounts.

No file chosen

I understand that by applying for BDIA membership, I am agreeing to abide by the BDIA Code of Practice.*

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info@bdia.org.uk

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