Update Periodontal Society Officers

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

Periodontal Society Directory

Members Only Content:

Not Member Only

INFORMATION ABOUT YOUR SOCIETY

Name of Society: *

Society Website Address:

Primary Society Contact Person: *

Approximate Number of Society Members: *

Your Name: *

Your Position: *

Your Email: *

Your Phone: *

INFORMATION ABOUT YOUR OFFICERS

Click the title of each officer whose name or contact information needs to be changed in your society's listing. Leave fields blank if you do not want them included in your listing or there is no change.

New Officers' Terms:

PRESIDENT

Name:

President's Address:

Phone:

Fax:

Email:

PRESIDENT-ELECT

Name:

President-Elect's Address:

Phone:

Fax:

Email:

VICE PRESIDENT

Name:

Vice President's Address:

Phone:

Fax:

Email:

SECRETARY

Name:

Secretary's Address:

Phone:

Fax:

Email:

TREASURER

Name:

Treasurer's Address:

Phone:

Fax:

Email:

EXECUTIVE DIRECTOR / OFFICE MANAGER

Name:

Office Address:

Phone:

Fax:

Email: