Application for Initial Provisional Regulated Member Registration
Registration form is to be completed and submitted online.
It is your responsibility to read, review and ensure that all required documents are completed including any fees that are invoiced.
The form will be received electronically and you will be advised when your application has been approved. Please be advised that until approved by the Registrar and a Practice Permit has been issued you cannot provide Denturist services directly to the public in the Province of Alberta
If you were previously registered with the College of Alberta Denturists as a Student, please contact the College office at (780) 429-2330; toll free at 1-800-260-2742; and or email the registrar at firstname.lastname@example.org .
If you were previously registered as a Student, you will be provided with a temporary user name and password.
- Log in to the member's side using the temporary user name and password.
- Review your current profile. To make changes and upload documents please use the "edit form" to change any information.
If you were NOT previously registered as a Student please select the applicable form. ( See Application Forms )
This is a legal document and as such you are required by law to provide truthful and complete responses to all requested information, both personal and business.
Please provide the response N/A if not applicable.
All numbered questions or items marked with an asterisk must be completed in order for you to continue to the next page.
Please note the entry for any date is as follows: Month/Day/Year
If using a credit card for payment, please ensure that the name provided is the name as it appears on the credit card and the billing address of the card holder is required for the payment to be processed.
Please scan and upload the following information:
- Current CPR Certificate
- If applicable Print, Sign, Scan and Upload - Provisional Regulated Member Supervised Employment Agreement ( one Supervisor - PDF); Two Supervisors (PDF)
- Print, Complete, Scan and upload Two Character Declaration Forms (PDF)
- Birth Certificate or documentation indicating legal entitlement to work in Canada
- Passport type photo
- Scan and upload an original Transcript of Marks and a copy of your Diploma in Denturst Technology from an Institute approved by the Council of the College of Alberta Denturists (as soon as available)
- Print, complete, scan and upload the College's “Provisional Regulated Member supervised Employment Agreement Form if you are going to be working in a denture clinic and providing patient services.
(Please note: If this form is not complete, returned and approved by the College, you cannot provide any patient services.)
- Scan and upload an original and current Criminal Record Check
Please refer to the College of Alberta Denturists Provisional Regulated Member Fees Policy (PDF)