Affiliate Fellow

Requirements

(Must meet either criterion 1 or 2 and must meet both 3 and 4)

  1. Applicant has attended or completed an ADA accredited Prosthodontic Residency and/or Maxillofacial Prosthetics Fellowship in the US, but does not qualify for associate fellowship at this time.
  2. Applicant has international training in dentistry, prosthodontics, or maxillofacial prosthetics or any of these levels of training in the US and who has an interest in maxillofacial prosthetics with no current desire to become a full fellow; is simply interested in maxillofacial prosthetics.
  3. Applicant is encouraged to be in good standing of the American Dental Association (ADA) or equivalent organization in the country in which they practice.
  4. Applicant must submit a completed application 60 days in advance to the annual AAMP meeting or the AAMP interim board meeting. The application must be submitted to the fellowship chair which includes a mission statement on becoming an affiliate fellow, and after validation by the fellowship committee, the candidate will be voted on for approval by the AAMP Board of Directors.
For any questions, please contact the Executive Secretary of the AAMP.

Personal Information














Academic Training

 InstitutionDegreeYear
Pre-Dental or Pre-Medical
Dental or Medical
Graduate

Post Graduate


Specialty Board Certification

Certified?
     



Fellow Program



Residential Program



Student Program







Teaching or Hospital Appointments


Research Experience




Names of two Active Fellows of the Academy from whom the Secretary may obtain an endorsement




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