Join Dental Trauma UK
To apply to become a member of Dental Trauma UK complete the form below. When the form is complete you'll be redirected to our secure payment provider so that you can pay the membership fee by credit card.
Payment type:
About you
Your title: *
Your first name: *
Your surname: *
Your practice / training institute name: *
Your primary contact details
Address line 1: *
Address line 2: (Optional)
Address line 3: (Optional)
City / Town: *
County / State / Region: (Optional)
Postal / ZIP code: *
Country: *
Your email address and telephone number
Your email address: *
Confirm your email address: *
Your telephone number: *
Your password
Your password: (Must contain between 5-15 characters) *
Contact permissions
Dental trauma UK will only use your personal information to administer your membership.
From time to time we would like to contact you about educational services via email.
Please see our privacy policy for more information.
I consent to Dental Trauma UK contacting me by email:
Please select what we can contact you about:
You may update your preferences at any time by logging into your member account.
Additional information
Please select your occupation: *
GDC number: (contact us if you are not registered with the GDC)
Year primary dental qualification obtained: (Optional)
Practice types: (Add all that apply)
Offer code: (Optional)
Cost (£):
30.00
Make payment
Cardholder name: *
Is the cardholder address the same as the primary address?