The Odontographic Society of Chicago
Dues Statement for 2023-2024
To All Active, Life, and Emeritus/Honorary Fellows of The Odontographic Society of Chicago:
Please provide the following information. Thank you.
Name:_________________________________________ E-mail Address: ______________________________
Preferred Mailing Address:______________________________________________________________________
Preferred Contact Phone Number:___________________________________
*****Must have E-mail address for meeting announcements.*****
Active Fellows: Dues to June 30, 2019 includes all three dinner meetings. $195.00
Research and Education contribution*** $50.00
Total $245.00
Additional Research and Education contribution __________________
Total ________
Life Fellows: Individual dinner costs are $60.00 per dinner meeting. $25.00
Research and Education contribution*** $50.00
Total $75.00
Additional Research and Education contribution __________________
Total ________
Emeritus/Honorary Fellows: Individual dinner costs are $60.00 per meeting. $00.00
Research and Education contribution*** $50.00
Total $50.00
Additional Research and Education contribution __________________
Total ________
Life, Emeritus, and Honorary Fellows: You can opt for the Dinner plan, with (3) dinners at $195.00. If you opt to do the Dinner plan, then your dues will be included in the $195.00.
***The Research and Education contribution is voluntary.
Please make checks payable to The Odontographic Society of Chicago, and mail payment, with a filled out copy of this statement to:
Dr. Roger Nouneh
636 Church St. STE #722
Evanston, IL 60201
Dues Statement for 2023-2024
To All Active, Life, and Emeritus/Honorary Fellows of The Odontographic Society of Chicago:
Please provide the following information. Thank you.
Name:_________________________________________ E-mail Address: ______________________________
Preferred Mailing Address:______________________________________________________________________
Preferred Contact Phone Number:___________________________________
*****Must have E-mail address for meeting announcements.*****
Active Fellows: Dues to June 30, 2019 includes all three dinner meetings. $195.00
Research and Education contribution*** $50.00
Total $245.00
Additional Research and Education contribution __________________
Total ________
Life Fellows: Individual dinner costs are $60.00 per dinner meeting. $25.00
Research and Education contribution*** $50.00
Total $75.00
Additional Research and Education contribution __________________
Total ________
Emeritus/Honorary Fellows: Individual dinner costs are $60.00 per meeting. $00.00
Research and Education contribution*** $50.00
Total $50.00
Additional Research and Education contribution __________________
Total ________
Life, Emeritus, and Honorary Fellows: You can opt for the Dinner plan, with (3) dinners at $195.00. If you opt to do the Dinner plan, then your dues will be included in the $195.00.
***The Research and Education contribution is voluntary.
Please make checks payable to The Odontographic Society of Chicago, and mail payment, with a filled out copy of this statement to:
Dr. Roger Nouneh
636 Church St. STE #722
Evanston, IL 60201