Submittable form for requesting changes and/or additions to the meetings, officers and other information listed in the online Periodontal Societies Directory and Calendar...

Periodontal Society Directory Update Form

Submit this form to update your society's online listing whenever you elect new officers or plan new meetings.

Please enter all of the required information and only the contact information that should be added or changed in your society's listing. When you have completed this form, click the "Submit Your Update" button near the bottom of the page.

Required Information

Name of society:
Who is the primary contact person for your organization?
Number of society members:
 
Your name:
Your position:
Your phone:
Your e-mail:
 

Optional Information for Your Periodontal Society Listing

Use the fields below to enter officer contact information that needs to be changed. Leave a field blank if it does not apply to your society or there is no change in what is already posted on the Academy's website.

Website address:
Term of office:From To
 
President:
Name:
Address:
City: State: Zip:
Country:
Telephone: Fax:
E-mail:
 
President-Elect:
Name:
Address:
City: State: Zip:
Country:
Telephone: Fax:
E-mail:
 
Secretary:
Name:
Address:
City: State: Zip:
Country:
Telephone: Fax:
E-mail:
 
Treasurer:
Name:
Address:
City: State: Zip:
Country:
Telephone: Fax:
E-mail:
 
Central Office:
Contact name:
Address:
City: State: Zip:
Country:
Telephone: Fax:
E-mail:
 

Meetings to Be Listed on Periodontal Societies Calendar

Meeting 1
Name of event:
Date(s):
Location:
Contact information:
Web Address:
 
Meeting 2
Name of event:
Date(s):
Location:
Contact information:
Web Address:
 
Meeting 3
Name of event:
Date(s):
Location:
Contact information:
Web Address:
 

If you have any questions about your listing or if you prefer to mail or fax your update form, please direct all communications to:

Education and Liaison Department
The American Academy of Periodontology
737 North Michigan Avenue, Suite 800
Chicago, IL 60611-6660
Phone: 312/787-5518
Fax: 312/787-3670
E-mail: PerioSocietyResources@perio.org