2027 Class 3- August CE Class Registration Form- VCDHA

2027 Class 3- August CE Class Registration- VCDHA

Thank you for choosing VCDHA Continuing Education!
Course Title: “Unlocking the power of Myofunctional Therapy” (1.5 hr) and “Understanding Deaf or Hard of Hearing Barriers in Dentistry” (1.5 hr)

Course Speaker: Amanda Zubricki, RDH, BS

Date: 8/7/27

CEU: 3

Timeline:

8:30am (PST) Log On
8:50am Announcments and then class begins
12pm Class Ends
Location: Virtual

Additional Information:
- Zoom link will be sent the day before class to registered attendees.
- Log on at 8:30am to work out any technical challenges prior to class.
- Annoucements will begin at 8:50am and class starts at 9am
- See VCDHA Website for Course Outline & Objectives and more information.
- Door prizes will be offered at all classes! We are excited to have you!
- Register today for the best price. Prices for individual classes increase closer to the event.
- Attention CE Bundle Attendees: If you registered for the bundle, you are automatically registered for each class and will not need to complete this registration step again. Watch for an email prior to the in-person classes to RSVP for lunch.
- Reminder, there are no refunds for missed classes.
Complete the registration form carefully.
Name (as it appears on your RDH license)

First NameLast Name
License Types
License Number (enter 0 if no license number)
CDHA Membership Status (membership status will be verified)
CDHA Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email to send your CE cert sent to
example@example.com
Email confirmation
example@example.com
Please carefully select the registration option(s) below that matches your attendee type.
Registration Options:
prevnext( X )
8/7/27 CDHA Member or RDA
$52.00 Quantity



8/7/27 Non-Member or Dentist
$70.00 Quantity



8/7/27 Dental Hygiene Student
Free Quantity



Total

$0.00
I have verified that I selected the correct registration option above and that there are no refunds for missed classes or incorrect registration.
Once you click "Checkout", you will be redirected to the payment page.

Once payment is submitted, we are then notified and you will receive a confirmation email with a detailed PDF with the information you gave us.
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2027 Class 3- August CE Class Registration- VCDHA

Registration Options:*

Registration Options: