1-2018

PLEASE PROVIDE INFORMATION BELOW TO REGISTER FOR the Events on June 20th, June 21st, June 27th, and June 28th (8 hours total)
Event Date:
I AM REGISTERING THE FOLLOWING NUMBER OF BCDA MEMBERS at $280/PERSON
I AM REGISTERING THE FOLLOWING NUMBER OF Non- BCDA MEMBERS at $375/PERSON
Total Due
Please remember your total due to submit payment (next page).
PLEASE LIST THE NAMES AND EMAILS OF REGISTRANTS ABOVE (FOR ZOOMLINKS/PASSCODES AND CERTIFICATE):
Make sure you receive your Zoom links and passcodes!
Add baltimorecountydental@gmail.com to your email contacts

PLEASE PROVIDE INFORMATION BELOW TO REGISTER FOR the Event on September 26th
Event Date:
I AM REGISTERING THE FOLLOWING NUMBER OF PEOPLE at $40/PERSON
Total Due
Please remember your total due to submit payment (next page).
PLEASE LIST THE NAMES AND EMAILS OF REGISTRANTS ABOVE (FOR ZOOMLINKS/PASSCODES AND CERTIFICATE):
Make sure you receive your Zoom links and passcodes!
Add baltimorecountydental@gmail.com to your email contacts

TOTAL DUE

USDPlease enter your total due above

Event Registration