Sample Member Application Form (Fellows, Students and Academic)

WFO Membership Application

Thank you for your interest in joining the World Federation of Orthodontists! We are excited to welcome you to our community. To apply for WFO membership, please complete the form below. Once submitted, your application will be reviewed for eligibility, and you will receive a response via email within two business days. If you have any questions, feel free to contact us at wfo@wfo.org or call us at our toll-free number 1-800-222-9969

Select Membership Category(Required)

To be eligible for WFO Fellow membership, you must be a fully credentialed orthodontic specialist in the country in which you practice. Non-specialists are not eligible. Student members must be enrolled in an orthodontic specialty program recognized by a WFO national affiliate organization where the program is held. Eligible non-orthodontic faculty members and qualified WFO members who retire may also apply for their membership status.

About You

Country of Practice(Required)

Please select the country where you are currently practicing

Country of Study(Required)

Please select the country where you are currently completing your studies

Your Name(Required)

First Middle Last

Date of Birth(Required)

Month

Day

Year

Gender

Male

Female

Primary Email(Required)

Secondary Email

Primary Phone Number(Required)

Secondary Phone Number

How do you want to be contacted?

Current Residence(Required)

Address must be in the country of practice or country of study

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Main Office/School/Teaching Facility Address

Same as current address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Education

Please spell out FULL NAME of the schools clearly

Dental School Attended(Required)

Date of Graduation(Required)

Month

Day

Year

Degree Acquired(Required)

Orthodontic School Attended(Required)

Date of Completion/Date of Graduation(Required)

Month

Day

Year

Orthodontic Degree Acquired (for certificate, enter "Certificate")(Required)

College Attended (Academics Only)

Date of Completion

Month

Day

Year

Degree

Post-graduate University Attended

Date of Completion

Month

Day

Year

Degree

Major Area of Emphasis

WFO Membership Fees (all amounts are in US Dollars)

Notes: 1. WFO fees are billed on the anniversary date of your original acceptance as a WFO member. 2. Student membership will automatically terminate upon graduation or upon termination of status as a student in an orthodontic program without satisfactory completion. 3. Payment details will be sent to your email once your application has been screened and approved.

WFO Fellow & Academic Membership

Select one

5-year fellowship $250 (US)

3-year fellowship $150 (US)

1-year fellowship $120 (US)

WFO Student Membership

Select One

3-year fellowship $55 (US)

2-year fellowship $45 (US)

1-year fellowship $25 (US)

Would you like to get One (1) WFO Lapel Badge/Pin? (Optional)

Yes, I'd like to get one (1) WFO Lapel Badge/Pin for an additional $25

Are you a member of a WFO affiliated National Organization in your country?(Required)

Yes

Choose where your organization located(Required)

Organization Name: Africa & the Middle East(Required)

Select the affiliated association you belong to

Organization Name: Central & East Asia(Required)

Select the affiliated association you belong to

Organization Name: Central & South America(Required)

Select the affiliated association you belong to

Organization Name: Europe(Required)

Select the affiliated association you belong to

Organization Name: North America(Required)

Select the affiliated association you belong to

Organization Name: Southeast Asia & Oceania(Required)

Select the affiliated association you belong to

Orthodontic Certificate Upload

A copy of your orthodontic degree or certificate (or a letter from your department chair verifying successful completion of your orthodontic program) must accompany this application.

File Upload(Required)

Drop files here or

Max. file size: 512 MB, Max. files: 1.

WORLD FEDERATION OF ORTHODONTISTS OATH for FELLOW AND STUDENT MEMBER

Confirmation(Required)

I have read, understand and agree to the statement below:

By way of submitting this application, I swear under oath that the answers to all questions on this application are true and complete to the best of my knowledge and that I am qualified to be a WFO member in the membership category to which I am applying. I also understand and agree that the WFO may investigate my qualifications. I further waive the right to hold the WFO, its affiliates, executive committee, officers, members and employees responsible for any damage as a result of the denial of this application or any other action taken by the WFO. I hereby agree to comply with the WFO Charter, Bylaws and Policies should I be approved for WFO membership.

WORLD FEDERATION OF ORTHODONTISTS OATH for ACADEMIC MEMBER

Confirmation(Required)

I have read, understand and agree to the statement below:

Name of dean, orthodontic department chair or program director(Required)

Title/Position(Required)

Dean

Department Chair

Program Director

Other

Dean/Department Chair/Program Director's Email:(Required)

WFO Membership Application

Select Membership Category(Required)

About You

Country of Practice(Required)

Please select the country where you are currently practicing

Country of Study(Required)

Please select the country where you are currently completing your studies

Your Name(Required)

First Middle Last

Date of Birth(Required)

Month

Day

Year

Gender

Male

Female

Primary Email(Required)

Secondary Email

Primary Phone Number(Required)

Secondary Phone Number

How do you want to be contacted?

Current Residence(Required)

Address must be in the country of practice or country of study

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Main Office/School/Teaching Facility Address

Same as current address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Education

Please spell out FULL NAME of the schools clearly

Dental School Attended(Required)

Date of Graduation(Required)

Month

Day

Year

Degree Acquired(Required)

Orthodontic School Attended(Required)

Date of Completion/Date of Graduation(Required)

Month

Day

Year

Orthodontic Degree Acquired (for certificate, enter "Certificate")(Required)

College Attended (Academics Only)

Date of Completion

Month

Day

Year

Degree

Post-graduate University Attended

Date of Completion

Month

Day

Year

Degree

Major Area of Emphasis

WFO Membership Fees (all amounts are in US Dollars)

WFO Fellow & Academic Membership

Select one

5-year fellowship $250 (US)

3-year fellowship $150 (US)

1-year fellowship $120 (US)

WFO Student Membership

Select One

3-year fellowship $55 (US)

2-year fellowship $45 (US)

1-year fellowship $25 (US)

Would you like to get One (1) WFO Lapel Badge/Pin? (Optional)

Yes, I’d like to get one (1) WFO Lapel Badge/Pin for an additional $25

Are you a member of a WFO affiliated National Organization in your country?(Required)

Yes

Choose where your organization located(Required)

Organization Name: Africa & the Middle East(Required)

Select the affiliated association you belong to

Organization Name: Central & East Asia(Required)

Select the affiliated association you belong to

Organization Name: Central & South America(Required)

Select the affiliated association you belong to

Organization Name: Europe(Required)

Select the affiliated association you belong to

Organization Name: North America(Required)

Select the affiliated association you belong to

Organization Name: Southeast Asia & Oceania(Required)

Select the affiliated association you belong to

Orthodontic Certificate Upload

A copy of your orthodontic degree or certificate (or a letter from your department chair verifying successful completion of your orthodontic program) must accompany this application.

File Upload(Required)

Drop files here or

Max. file size: 512 MB, Max. files: 1.

WORLD FEDERATION OF ORTHODONTISTS OATH for FELLOW AND STUDENT MEMBER

Confirmation(Required)

I have read, understand and agree to the statement below:

WORLD FEDERATION OF ORTHODONTISTS OATH for ACADEMIC MEMBER

Confirmation(Required)

I have read, understand and agree to the statement below:

Name of dean, orthodontic department chair or program director(Required)

Title/Position(Required)

Dean

Department Chair

Program Director

Other

Dean/Department Chair/Program Director's Email:(Required)