Date:
Name:
  AM PM Both
ADHA Member $50.00 $50.00 $80.00
Non-Members (RDH, DDS, DMD) $65.00 $65.00 $95.00
Dental Assistants $40.00 $40.00 $75.00
DH Students $25.00 $25.00 $35.00



Group Registration

Date:
     
Name: Credential: Course:
Name: Credential: Course:
Name: Credential: Course:
Name: Credential: Course:
Name: Credential: Course:
Name: Credential: Course: