Membership Registration Form (Middle/High School)

NOTE: You will need to have your parent/guardian sign, print and submit this form, and mail or fax it to us. Application Deadline: October 1. Return your completed form by regular mail or fax to:

Ms. Willie Alexander, Education Program Coordinator Office of Student Development Texas A&M College of Dentistry 3302 Gaston Ave. Dallas, TX 75246 Office: 214-828-8987 Fax: 214-874-4502