1-2018

PLEASE LIST YOUR GUEST INFORMATION BELOW TO REGISTER FOR THE EVENT.
I AM REGISTERING THE FOLLOWING NUMBER OF BCDA MEMBER AND GUESTS AT $55/PERSON
I AM REGISTERING THE FOLLOWING NUMBER OF NON BCDA MEMBERS AND GUESTS AT $60/PERSON
Total Due
Please remember your payment total as you will need to enter this total when you submit your payment after submitting this registration form.
Please list the names of registrants above. Be sure to include yourself:

Registration for 11/16/2018
PLEASE LIST YOUR GUEST INFORMATION BELOW TO REGISTER FOR THE EVENT ON 11/16/2018
I AM REGISTERING THE FOLLOWING NUMBER OF DENTISTS AT $270/PERSON
I AM REGISTERING THE FOLLOWING NUMBER OF STAFF MEMBERS AT $145/PERSON
Total Due
Please remember your payment total as you will need to enter this total when you submit your payment after submitting this registration form.
PLEASE LIST THE NAMES OF THE REGISTRANTS ABOVE. PLEASE MAKE SURE TO INCLUDE YOURSELF:

Seating, meals and CE credits will NOT be reserved without payment.

Please remember your payment total as you will need to enter this total when you submit your payment after submitting this registration form.

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Event Registration