Form for updating the AAP Web site's information about the faculty members in charge of a dental school's periodontics program...

Faculty Registry Update Form

Use this form to list your school's perio program chair, predoctoral and postdoctoral directors, and dean in the AAP's faculty registry.

Required Information

  1. Name of your university or institution (required):

  2. Your name (required):

  3. Your e-mail address (required):

Optional Updates

If your program already has an AAP faculty registry page, do NOT reenter all of the information requested below. Enter ONLY what needs to be changed on your page, and leave other fields blank. If one person holds multiple positions, enter his/her phone, fax, and e-mail once.

  1. Name of your dental school or program:

  2. Address of your program (include street address, city, state, and zip):



  3. PROGRAM CHAIR
    Program Chair's Name:

    Program Chair's Phone:

    Program Chair's Fax:

    Program Chair's E-mail:



  4. POSTDOCTORAL DIRECTOR
    Postdoctoral Director's Name:

    Postdoctoral Director's Phone:

    Postdoctoral Director's Fax:

    Postdoctoral Director's E-mail:



  5. PREDOCTORAL DIRECTOR
    Predoctoral Director's Name:

    Predoctoral Director's Phone:

    Predoctoral Director's Fax:

    Predoctoral Director's E-mail:



  6. DEAN
    Dean's Name:

    Dean's Phone:

    Dean's Fax:

    Dean's E-mail: