Become a Member | Alpha Omega

You can register to become a member online or by mail.

Mail:
Please include the same information as requested below in the online form.
Make cheque payable to: “Alpha Omega Dental Fraternity”
Mail to: Dr. Gary Hyman
Alpha Omega Manitoba Chapter
22-1800 Wellington Crescent
Winnipeg, Manitoba R3P 2E7

Online:

Name*
First Last
Email*
Work Phone*
Work Address*
Street Address Address Line 2 City Province Postal Code
Home Phone
Home Address
Street Address Address Line 2 City Province Postal Code
Spouse's Name
First Last
School or Institution of Graduation
Year Graduated
Type of Membership*
A receipt will be issued upon payment of dues.
Donation

A donation to the Alpha Omega Foundation would be greatly appreciated. Read more. Tax receipts will be issued for donations over $25.
Total
$ 0.00 CAD
Comments
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