2024 Continuing 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 download the Registration Form PDF, fill it out and mail it to us. We cannot accept an online registration for checks. Thank you.

Mail: DSDS, 892 Eichele Road, Perkiomenville, PA 18074

Name:
Title:
Employer's Name:
(Staff registrants only)
Office Address:
City:
State:
Zip Code:
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:

May 8, 2024
The Future of Dental Marketing with Artificial Intelligence - Adrian Lefler
WEBINAR – 7:00 PM – 8:30 PM
Course Cost: $25
May 17, 2024
DSDS 161st ANNUAL SESSION
Turning Ordinary Into Extraordinary - Dr. Ankur Gupta
FULL DAY IN-PERSON - 8:30 AM - 4:00 PM
DSDS/ADA Member
$315.00 - before May. 10
$335.00 - after May. 10		 NonADA Member
$415.00 - before May. 10
$435.00 - after May. 10		 Staff/Student/Spouse
$175.00 - before May. 10
$195.00 - after May. 10

TOTAL REGISTRATION $0

 
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Delaware State Dental Society
892 Eichele Road
Perkiomenville, PA 18074-9510
Phone: 302-368-7634
Email:
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