Application for Full membership - Dental Technicians The BACD currently has two different levels of membership. Full member status is available to those BACD technician members in good standing who have carried out 30 hours of relevant verifiable CPD (see below) within the last two years. Please put contact details as you would like them listed on our web directory. Title:__________________ BACD Membership No:____________________________ First name:_____________________ Surname:___________________________________ Lab Address:_______________________________________________________________ __________________________________________________________________________ __________________________________ Postcode:____________________________ Phone:____________________________ Fax:________________________________ Website:___________________________________________________________________ Email:_____________________________________________________________________ Please note the following provisos: Reading magazine articles is not accepted On-line courses approved by the BACD are acceptable to a maximum of 10 hours Your submission can include a maximum of 5 hours of surgical implant courses Your submission can included a maximum of 5 hours of occlusion courses Your submission must include 6 hours attendance at BACD meetings. BACD verifiable CPD is from conferences/regional meetings/lectures organised by the BACD and not simply sponsored by the BACD Maintenance of full membership will require 30 hours of relevant verifiable CPD to be submitted every 2 years from the date of acceptance of full membership by BACD. This must include 6 hours attendance at BACD meetings Relevant CPD subjects cover the full spectrum of education in cosmetic dentistry including 1. 2. 3. 4. 5. 6. 7. 8. Smile design Ceramic restorations Composite resin restorations Aesthetic bridges and pontics Anterior implants/implant aesthetics Adhesion Materials Colour in dentistry 9. 10. 11. 12. 13. 14. 15. Whitening Aesthetic soft tissue management Posterior aesthetic restorations Occlusion Laboratory communication Photography/cosmetic imaging Orthodontics Please list relevant verifiable CPD below and attach COPIES of attendance certificates to this form PLEASE ATTACH YOUR CERTIFICATES IN THE ORDER THAT THEY ARE LISTED ON THE FORM BELOW! Date Name of course Speaker(s) Venue Hours I wish to apply for Full Membership of the British Academy of Cosmetic Dentistry and have attached the following (please tick to confirm): □ □ □ □ Completed form, including all relevant contact details Completed verifiable CPD listing Copies of all CPD certificates attached in the same order as listed 6 BACD hours included I agree to abide by the rules and by-laws of the Academy. I further agree to abide by the Academy’s guidelines for announcing and advertising my membership of the Academy Signature:______________________________________ Date:_____________________ Send form to: Suzy Rowlands, BACD, 29 Harley Street, London W1G 9QR