2026 GAGD Annual Meeting Registration Form

First Name*

Last Name*

Badge Name*

Designation

FAGDMAGDLLSR

What is your designation?*

DoctorHygienistStudent

Hygienists may register for Track 1 only if their Practice Doctor is also registered. Track 2 is not open to Hygienists.

Are you a AGD Member?*

YesNo

AGD #

Dental Practice/Other*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

Phone Number*

Please make a lunch entree selection:*

Honey Maple Turkey & Swiss on Sourdough with Lettuce, Tomato, and AvocadoHoney Maple Ham & Cheddar on Wheat with Lettuce, Tomato, and BaconPastrami & Provolone on Rye with Lettuce, Tomato, and Horseradish AioliVegetarian

Do you have any dietary restrictions?

Registration Options*

Non-Member Track 1$895.00

Dentistry's Next Great Frontier: Integrative Dental Medicine with Dr. DeWitt Wilkerson and Lora Hooper

GAGD Member Track 1$695.00

Dentistry's Next Great Frontier: Integrative Dental Medicine with Dr. DeWitt Wilkerson and Lora Hooper

Hygienist Track 1$495.00

Hygienists May Only Register If Practice Doctor Will Also Be Attending

GAGD Student Member - Track 1$49.00

Dentistry's Next Great Frontier: Integrative Dental Medicine with Dr. DeWitt Wilkerson and Lora Hooper.

Non-Member Track 2$895.00

Financial and Business Strategies for Every Stage of Ownership with Wes Lyon

GAGD Member Track 2$695.00

Financial and Business Strategies for Every Stage of Ownership with Wes Lyon

GAGD Student Member - Track 2$49.00

Financial and Business Strategies for Every Stage of Ownership with Wes Lyon

Sponsor a Student!$22.00

Your donation will sponsor the future of your profession by covering the cost of a AGD student membership.

Enter coupon

Total $0.00

Credit Card

Refund requests submitted in writing before January 1, 2026 will receive a 50% refund. Cancellations after January 9, 2026 and no-shows will not receive a refund.

Georgia Academy of General Dentistry Annual Meeting Registration Form

Attendee Contact Information

Registration Information

Credit Card