Date:
Name:
  AM PM Both
ADHA Member $55.00 $55.00 $85.00
Non-Members (RDH, DDS, DMD) $65.00 $65.00 $95.00
Dental Assistants $45.00 $45.00 $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: