Individual Membership Application

This form is for individual membership applicants (Professional, Pre-Professional, Vendor, Associate, or Emeritus). If you are applying for an institutional membership, please refer to the ORAHEAD Institutional Membership Application. The information below will be used for administrative and accounting purposes. To pay membership fees after filling out this application, please refer to Payment Options below.

Privacy Notice for ORAHEAD Members

Your membership information will be included in a members-only membership directory. Information displayed may include Name, Title, Phone, and E-mail Address.

Information Collection, Use, and Sharing

ORAHEAD is the sole owner of membership information collected. We only have access to/collect information that you voluntarily give us by joining ORAHEAD. We will not sell or rent this information to anyone. We will use your information to respond to you, regarding organization business. We will also provide this information as a benefit of membership to other ORAHEAD members. We will utilize your contact information to add you to the ORAHEAD Listserv as a benefit of membership. We will not share your information with any third party outside of our organization, other than as necessary to perform organization business.

Please note that applicants must submit this portion of the application before reviewing and submitting payment options. Select Send to submit.

Payment Options

Pay by Debit/Credit Card

In order to pay via credit or debit, a PayPal account is required. PayPal accepts Visa®, MasterCard®, Discover® and American Express® debit and credit cards.

Please enter total membership application fees under Item Price when prompted.

Institution or Organization
Paying for multiple people?

Pay by Check

Please mail your check to ORAHEAD at:
1819 SW 5th Ave.
PM Box 273
Portland, OR 97201.

Please Note that we have a new business address.