Continuing Dental Education Registration Form

NOTE: Please register one person per form submission. To register multiple people, return to this page and submit a new form for each person.

This form is for paying by credit card only. If you want to pay by check or purchase order, you must go back to the Courses page and download the PDF, fill it out and mail it to us. We cannot accept an online registration for checks. Thank you.

Name:
Title:
(as it should appear on your tag...DR., MR., MRS., MS.)
Employer's Name:
(Staff registrants only)
Office Address:
City:
State:
Zipcode:
Office Phone:
Emergency Phone:
Email:
(Registration Confirmation will be sent via Email Only one week prior to the course)

Registration Categories (select one only)

DSDS/ADA Dentist
Non-DSDS/ADA Dentist
Dental Hygienist
Dental Assistant
Office Manager/Staff
Resident
Student
Spouse

REGISTRATION FEE:

Five Program Package - One Dentist & One Staff Person
DSDS/ADA Member - $1300.00 NonADA Member - $1775.00 Staff/Student/Resident/Spouse - $700.00
January 24, 2014 - Howard S. Glazer, DDS
What's Hot and What's Getting Hotter!!
DSDS/ADA Member
$290.00 - before Jan 10
$315.00 - after Jan 10
NonADA Member
$390.00 - before Jan 10
$415.00 - after Jan 10
Staff/Student/Resident/Spouse
$150.00 - before Jan 10
$1175.00 - after Jan 10
February 21, 2014 - Robert A. Levine, DDS, FCCP & Steven I. Present, DMD
From Straightforward to Complex, A Team Approach to Implant
Dentistry: A Formula for Success
DSDS/ADA Member
$290.00 - before Feb 7
$315.00 - after Feb 7
NonADA Member
$390.00 - before Feb 7
$415.00 - after Feb 7
Staff/Student/Resident/Spouse
$150.00 - before Feb 7
$1175.00 - after Feb 7
March 21, 2014 - John K. McGill, CPA, MBA
Achieving Financial Independence
DSDS/ADA Member
$290.00 - before Mar 7
$315.00 - after Mar 7
NonADA Member
$390.00 - before Mar 7
$415.00 - after Mar 7
Staff/Student/Resident/Spouse
$150.00 - before Mar 7
$1175.00 - after Mar 7
April 11, 2014 - Nicholas R. Conte, Jr., DMD, MBA
Clinical and Material Factors in Achieving the Ideal Impression
8:30 Registration, 9-11 Lecture, 11-12 Tour, 12-1 Lunch
Dentsply Caulk Facility, Milford, DE
Registration deadline Apr. 3 - Course Limited to 30 DSDS Dentists - Cost $50.00
September 19, 2014 - Harold L. Crossley, DDS, PhD
Medical and Dental Implications of the Most Prescribed Medications
DSDS/ADA Member
$290.00 - before Sep 5
$315.00 - after Sep 5
NonADA Member
$390.00 - before Sep 5
$415.00 - after Sep 5
Staff/Student/Resident/Spouse
$150.00 - before Sep 5
$1175.00 - after Sep 5
October 17, 2014 - Nicholas R. Conte, Jr., DMD, MBA
Successful, Predictable & Efficient Direct Composite Restorations
8:30 Registration, 9-11 Lecture, 11-12 Tour, 12-1 Lunch
Dentsply Caulk Facility, Milford, DE
Registration deadline Oct. 3 - Course Limited to 30 DSDS Dentists - Cost $50.00
November 21, 2014 - Stanley F. Malamed
Emergency Medicine in Dentistry
DSDS/ADA Member
$290.00 - before Nov 7
$315.00 - after Nov 7
NonADA Member
$390.00 - before Nov 7
$415.00 - after Nov 7
Staff/Student/Resident/Spouse
$150.00 - before Nov 7
$1175.00 - after Nov 7
  May 9, 2014 Mark Your Calendar - 151st Annual Session featuring Bruce Christopher
(registration information will be available in Mar.)


TOTAL REGISTRATION $0

 
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