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Australian Dental Industry Association
To submit a member application, complete the form below and pay the $250 application fee.
Once submitted and payment is received, your application will be processed for consideration by the ADIA Board.
ADIA Corporate Membership - is for businesses that have, sell or distribute an ARTG product which is listed on the TGA Australian Register of Therapeutic Goods.
ADIA Affiliate Membership - is for those businesses that supply services and products (other than those which appear on the TGA Australian Register of Therapeutic Goods) to dental professionals.
Turnover
Check this box to confirm that:With respect to the Applicant, it is declared that in the preceding five (5) years the applicant, its directors and senior management have not been: a. Convicted of an offence involving fraud, dishonesty or theft; b. Declared bankrupt or an undischarged bankrupt; c. A director of a company placed into liquidation or entered into an arrangement with its creditors for the relief of its debts; d. Convicted of a breach of the Corporations Act (Cth) 2001.and that the Applicant will abide by the ADIA Code of Practice for the duration of membership and as otherwise contractually required.
Check this box to confirm that:
With respect to the Applicant, it is declared that in the preceding five (5) years the applicant, its directors and senior management have not been:
a. Convicted of an offence involving fraud, dishonesty or theft;
b. Declared bankrupt or an undischarged bankrupt;
c. A director of a company placed into liquidation or entered into an arrangement with its creditors for the relief of its debts;
d. Convicted of a breach of the Corporations Act (Cth) 2001.
and that the Applicant will abide by the ADIA Code of Practice for the duration of membership and as otherwise contractually required.
By signing your name, checking this box and submitting this form you agree to the ADIA Terms & Conditions.
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