I hereby acknowledge and confirm that:
- I have read and understood this form.
- All information I have entered is true and accurate.
- I am a qualified denturist registered with the College of Denturists of Ontario to practise denturism in Ontario.
- I agree to pay the applicable membership fees as set out above
I hereby authorize DAO, DAC, The College of Denturists of Ontario, DAO’s brokers, insurer, group benefits providers and any other third parties that may assist DAO (now or in the future) with administering or managing DAO or its membership services, administration or benefits processes, to collect, use, disclose, retain and transfer my Personal Information, in electronic or other form, for the purpose of evaluating my membership application and for implementing, administering and managing my membership in DAO and providing me with membership services and group benefits. I understand that my Personal Information will be held only as long as is necessary to implement, administer and manage my membership in DAO and to provide me with membership services and group benefits.
I declare that my answers given in this Membership Application are full, true, accurate and complete and that they contain no untrue or misleading statement nor any omission of a material fact. I UNDERSTAND THAT ANY CONCEALMENT, MISREPRESENTATION OR FALSE DECLARATION IN THIS FORM OR IN ANY SUPPORTING DOCUMENTATION COULD CAUSE MY APPLICATION FOR MEMBERSHIP TO BE REJECTED OR MY MEMBERSHIP TO BE TERMINATED.
I agree to abide by the Code of Ethics of the Denturist Association of Ontario as amended or replaced from time to time, which outlines the general principles of conduct, duties and responsibilities to which members of the Association are expected to adhere in their relationships with the public, with their patients and with their fellow practitioners.