Continuing Education Series

2025 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 2, 2025
BECOME EXTRODINARY: How Identifying with both Your Team and Your Patients Drives a Productive Environment and Delivers the Care Patients Want - Dr. Louis Kaufman

DSDS/ADA Member
$335.00 - before Apr. 21
$385.00 - after Apr. 21

NonADA Member
$455.00 - before Apr. 21
$495.00 - after Apr. 21

Staff/Student/Spouse
$195.00 - before Apr. 21
$225.00 - after Apr. 21

TOTAL REGISTRATION $0