Northwest Indiana Dental Society - March Membership Meeting
Wednesday, March 18, 2026 at 6:00 PM
Birdies Next Door
218 E Lincolnway, Valparaiso, IN 46383
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Will you be bringing a non-dentist guest?
*
Please Select
Yes
No
A fee of $50.00 per non-dentist guest will be invoiced following registration.
How many non-dentist guests will you be bringing?
A fee of $50.00 per non-dentist guest will be invoiced following registration.
How would you like us to send you your invoice?
Text it to me
Email it to me
What email address would you like the invoice sent to?
example@example.com
What phone number would you like this invoice texted to?
Please enter a valid phone number.
Format: (000) 000-0000.
Non-Dentist Guest Fee Total (To Be Invoiced)
If you indicated that you are bringing a non-dentist guest, a $50.00 guest fee will be invoiced to you via your selected delivery method. Payment is due within 24 hours of registration. Unpaid registrations may be released to accommodate other attendees.
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