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Renew Your Membership

Thank you for renewing your membership. You may choose from the following membership category options:

ACTIVE - Active membership consists of corporations, partnerships, and individuals operating dental laboratories in the states of Minnesota, Iowa, Nebraska, North Dakota, South Dakota or Wisconsin, as well as dental laboratories operated within these states that are branches of other out-of-state laboratories. When both the home and branch offices of dental laboratories are located within one of these states, then only the home office will be accepted as an active member.
-- Owner-Operators – those labs with the owner being the sole technician on the payroll. $125.00
-- Laboratories – any lab with two or more technicians on the payroll. $175.00

AFFILIATE - Affiliate membership shall consist of dental laboratories of University dental schools, noncommercial dental laboratories, schools of dental technology, manufacturers, suppliers, and retailers. The cost of this membership is $125 per year.

INDIVIDUAL TECHNICIANS OR INDIVIDUAL CERTIFIED DENTAL TECHNICIANS (C.D.T.) - Individual membership consists of Individual Technicians or CDTs who have no proprietary financial interest in a commercial dental laboratory. Individual members may not be listed at a lab address or phone. The cost of this membership is $50 per year.

Click here if you wish to download a 2012 Membership Application

Please complete the form below.

Laboratory Name

(required)

Address

(required)

City

(required)

State

(required)

Postal Code

(required)

Phone Number

(required)

Fax Number

Website

Lab Owner/Main Contact Name

(required)

Lab Owner/Main Contact Title

(required)

LabOwner/Main Contact CDT?

Email Address

(required)

Additional Lab Owner/Contact Name

Additional Lab Owner/Contact Title

Additional Lab Owner/Contact CDT?

Additional Lab Owner/Contact Email

Is your laboratory certified?

CDL
DAMAS
ISO

If yes, in what area(s)?

Does your lab scan?

Yes
No

Does your lab mill?

Yes
No

Committee Interest

Communications
Education/Programs
Legislative/Outreach

Dues Payment

Mailing Check
VISA or MasterCard
(required)

Midwest Dental Laboratory Association
2345 Rice Street, Suite 220 | St. Paul, MN 55113
Phone 651-317-8065 -- Fax 651-317-8048
Email info@mwdentallab.org
Website www.mwdentallab.org