Applications & Waivers
General Membership Application
The American Dental Association has developed an Online Universal Membership Application. This system is specifically designed for new applicants who have never previously held membership in the Connecticut State Dental Association. Click the button below and follow the steps to submit your application to the CSDA. You will be emailed a link to pay your dues once we complete the processing of your membership application.
Download - Membership Application
Affiliate Membership
Active, Retired and Life members of the ADA from other states may join our association as an Affiliate member. This category is also available to members of the ADA who are employed by or serve on active duty with one of the federal dental services on a full time basis.
Download - Membership Form Application
Graduate Student Membership
If you are enrolled full-time in an eligible advanced training course, you may be eligible for Graduate Student Membership. If you are entering a graduate program immediately following dental school graduation, Graduate Student Membership maintains your eligibility for the ADA Reduced Dues Program for recent graduates.
Download - Graduate Membership Form
Humanitarian Practitioner Application
A category of membership in the ADA is available to dentists who are serving dentistry full-time for a humanitarian organization and who are receiving neither income nor a salary for that service other than a subsistence amount which approximates a cost of living allowance. The member must remain in service continuously for a least one year and not supplement his or her income by the performance of services as a member of the faculty of a dental or dental auxiliary school, as a dental administrator or consultant or as a practitioner of any activity for which a license to practice dentistry or dental hygiene is required.
Download - Humanitarian Practitioner Application
Retired Membership
Retired membership is available to an active member in good standing who is no longer earning an income from dentistry. For dentists retiring from tripartite membership, the Retired Member Membership Affidavit Form must be approved by your local dental society.
Download - Retirement Affidavit
Dues Waivers
A full or partial waiver is available to a member in good standing whose circumstances have resulted in a significant financial hardship. Dentists earning a subsistence income while working full-time for a charitable organization may also apply for a dues waiver.
