Membership Information Southern California Orofacial Academy

There is a one-time application fee of $500 ($250 for academic and retired oral and maxillofacial surgeons). Please fill out application form below.

Annual Membership Dues Can Be Paid Online (click here to pay dues)

OMS Residents - membership is free. Please fill out the form
below and enter the name of your training program and year of
completion in the Comments box.

CLICK HERE TO PAY APPLICATION FEES ONLINE

PLEASE FILL OUT APPLICATION FORM BELOW

To request membership information, please complete the form below
or call Susan Smith at 626 287-1185.
*Bold fields are required*
*Name:*
*Degree(s):*
*Address:*
Address (cont):
*City:*
*State / Province:*
*Zip Code:*
*Phone:*
Phone 2:
Fax:
*Email:*

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