Membership Forms

Tripartite Membership Application

To become a member of the American Dental Association (ADA), Maryland State Dental Association (MSDA) and your local component, please complete a Membership Application. When you submit this application, you will be contacted by our membership department to receive a quote for your annual dues.

Affiliate Member Application

If you are a member of another ADA state association and would like to also be a member of the Maryland State Dental Association, please complete this form.

Associate Member Application

If you are NOT a dentist and would like to become a member of the Maryland State Dental Association, please complete this form.

Dues Waiver

If you are experiencing a financial hardship and would like to request assistance with your dues payment, please complete this form.

RetireD Affidavit

If you are retiring, please complete this form and we will move you over to retired status and you can start receiving your discounted dues.