2019 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:

2019 Five Program Package - One Dentist
DSDS/ADA Member - $1100.00 NonADA Member - $1475.00
February 1, 2019
Dental Insurance Reimbursement & New Codes - Tom Limoli, Jr.
DSDS/ADA Member
$315.00 - before Jan 18
$335.00 - after Jan 18
NonADA Member
$415.00 - before Jan 18
$435.00 - after Jan 18
Staff/Student/Spouse
$175.00 - before Jan 18
$195.00 - after Jan 18
March 29, 2019
Functional Considerations in Esthetic Dentistry - Thomas McDonald, DMD
DSDS/ADA Member
$315.00 - before Mar 15
$335.00 - after Mar 15
NonADA Member
$415.00 - before Mar 15
$435.00 - after Mar 15
Staff/Student/Spouse
$175.00 - before Mar 15
$195.00 - after Mar 15
September 27, 2019
Introduction to Dental Sleep Medicine for the General Dental Team & Practical Dental Sleep Medic - Steve Carstensen, DDS
DSDS/ADA Member
$315.00 - before Sep 13
$335.00 - after Sep 13
NonADA Member
$415.00 - before Sep 13
$435.00 - after Sep 13
Staff/Student/Spouse
$175.00 - before Sep 13
$195.00 - after Sep 13
October 25, 2019
Prep N' Produce: A Comprehensive Guide to Prep Design, Indirect Material Selection and the Glues We - Timothy Bizga, DDS
DSDS/ADA Member
$315.00 - before Oct 11
$335.00 - after Oct 11
NonADA Member
$415.00 - before Oct 11
$435.00 - after Oct 11
Staff/Student/Spouse
$175.00 - before Oct 11
$195.00 - after Oct 11
November 22, 2019
Infection Control & OSHA Update - John Molinari, Ph.D (AM Lecture)
(Lunch not included with AM Course)
DSDS/ADA Member
$145.00 - before Nov 8
$155.00 - after Nov 8
NonADA Member
$205.00 - before Nov 8
$215.00 - after Nov 8
Staff/Student/Spouse
$80.00 - before Nov 8
$90.00 - after Nov 8
November 22, 2019
The Wallectectomy - Embezzlement in the Dental Practice - Pat Little, DDS (PM Lecture)
(Lunch included with PM course)
DSDS/ADA Member
$155.00 - before Nov 8
$165.00 - after Nov 8
NonADA Member
$205.00 - before Nov 8
$215.00 - after Nov 8
Spouse Only
$90.00


TOTAL REGISTRATION $0

 
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Christiana Executive Campus
200 Continental Drive
Suite 111
Newark, Delaware 19713
Phone: 302-368-7634
Fax: 302-368-7669
Email: