NDDA Membership Application

Please print the application from your web browser using the browser print command or the print button below, fill in the information requested, and return with your dues remittance. The NDDA calendar year is June 1st - May 31st.

Date: __________________

Name:
Home Street Address:
Home City/State/Zip:
Home Phone:
Home Fax:
Employer:
Work Address:
Work City/State/Zip:
Work Phone:
Work Fax:
Preferred E-Mail Address:

SPECIALTY AREAS OF PRACTICE:
(1)_______ (2)_______ (3)_______ (4)_______ (5)_______ (enter up to 5 codes from the list below)

A.D.A. Membership Type (REQUIRED):
Active     Retired     Student
A.D.A. Membership Number (REQUIRED):
 
NDDA Regular Membership Fee:
$30.00
If postmarked after Sept. 30:
$35.00
Student/Intern Membership:
$12.00
To receive NDDA quarterly newsletters by mail, add:
$4.00
Total:
 

MAKE YOUR CHECK PAYABLE TO:
Nashville District Dietetic Association

CHECKS SHOULD BE MAILED TO THE MEMBERSHIP CHAIR:
Laura Dowland
1635 Brentwood Pointe
Franklin, TN 37067

  Print The Application

Specialty Areas of Practice

Specialty Area Code   Specialty Area Code
Acute Care 1   Maternal and Child Health 22
AIDS/HIV 2   Neonatal 23
Alternative Therapy 3   Nutrition Support (Adult) 24
Breast feeding - education/promotion 4   Nutrition Support (Pediatric) 25
Business & Corporate Nutrition Programs 5   Oncology 26
Clinical Nutrition Management 6   Pediatrics 27
Communication & Media 7   Pharmaceutical Industry 28
Computer & Information Systems 8   Private Practice 29
Culinary Industry 9   Public Health 30
Developmental/Psychiatric Conditions 10   Rehabilitation, Alcohol and Drug 31
Department Management 11   Rehabilitation, Cardiac/Pulmonary 32
Diabetes (Adult) 12   Renal 33
Diabetes (Pediatric) 13   Research 34
Durable Medical Equipment (DME's) 14   School Food Service 35
Eating Disorders 15   Sports Nutrition 36
Education 16   Subacute and Step Down units 37
Food Manufacturers/Distributors 17   Transplantation 38
Food Service Management 18   Vegetarian 39
Home Health 19   Weight Management 40
Jails and Prisons 20   Wellness 41
Long Term Care 21      

The purpose of this listing is twofold: (1) to facilitate networking among members and, (2) to utilize the database to identify dietitians and dietetic technicians practicing within specific areas. Rapid identification is essential in responding to issues related to reimbursement, legislation, or CEU opportunities.