General Membership Meeting Registration Form
Wednesday, March 27, 2024

Register for the DSDS Business Meeting, and/or place dinner reservations, by March 25.

Please complete the information below to register.
No refunds can be offered.

There is a charge of $60/person to attend the Buffet Dinner. Payments may be made by credit card using the registration form below. If you wish to pay by check or purchase order, please download, print and complete the Registration Form PDF, and return it via email or mail. Checks should be made payable to DSDS and mailed to the address below. If using a check, also email DSDSTOM@comcast.net to be placed on the attendance list.

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

Email: DSDSTOM@comcast.net

Name:
Title:
Membership Type:
Employer's Name:
(Staff registrants only)
Office Address:
City:
State:
Zip Code:
Office Phone:
Emergency Phone:
Email:
(Registration Confirmation will be sent via Email approximately one week prior to the course.)

REGISTRATION FEE:

BUFFET DINNER - 6:00 PM - 8:00 PM

$60.00

DSDS BUSINESS MEETING – 6:30 PM - 7:00 PM

EVENING PROGRAM - 7:00 PM - 8:30 PM

Anne Farley, PhD. - First State Strategies

Update on the Legislative Issues Facing the Dental Profession

Other Attendees:

TOTAL REGISTRATION $0.00

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