AADE Logo Certified Dental Editor (CDE)
Application Form for CDE

This is your application for CDE recognition. It should be submitted only after you have completed all CDE designation requirements. The deadline each year for consideration is July 1st. CDE designations are awarded each fall at the AADE Annual Conference.

Your Name:

Dental Publication:

Publication Sponsor: 

Business Address: 
City:   State: Zip Code:

Business Telephone: 

Home Telephone:

e-mail:

Are you currently an AADE Member?  Yes   No

Journalism Continuing Education Hours Achieved

Please complete the requested information below. Attach evidence of completion of continuing education activities to this application. Evidence can include a copy of a certificate, verification form or letter from a granting organization that states the title of the meeting or course, location, date(s), number of continuing education hours and the instructor(s) name(s).
Course/Meeting Title:
Date(s):
Sponsor:

Number of Completed CE Hours and Subject Codes:
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Course/Meeting Title:
Date(s):
Sponsor:

Number of Completed CE Hours and Subject Codes:
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Course/Meeting Title:
Date(s):
Sponsor:

Number of Completed CE Hours and Subject Codes:
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Course/Meeting Title:
Date(s):
Sponsor:

Number of Completed CE Hours and Subject Codes:
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Course/Meeting Title:
Date(s):
Sponsor:

Number of Completed CE Hours and Subject Codes:
Hours: Code:
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The following number of CE hours from the courses or meetings that I attended and am reporting were sponsored by a dental organization: Hours

I attest that the information I am providing is truthful.

Signature:______________________________________________________________    Date:

Mail the completed application, supporting evidence attachments and a check for $150.00 made payable to: “American Association of Dental Editors” before July 1, 2009 to the AADE