Membership Application

Category of Membership

Select One:


  • Full Members (Complete sections 1-4)
  • Associate Member (Complete sections 1 and 2)
  • Individual Member (Complete section 1 only)

1. Contact Information


2. Names and Titles of Key Company Executives

(for plan and associates only)


3. Dental Plan Information Only


4. Delegate: Indicate person who will have authority from your company to vote on CADP Matters:

PRICES:

  • Associate Dues: $1,517 annually
  • Individual Dues: $210 annually
  • Plans: Based on weighted enrollment multiplied by per enrollee rate. Email chapinr@cadp.org for an estimate.
After submitting this form, Rene Chapin with CADP Membership will be contacting you for payment information.