2019 AP Westfall Registration

2019 AP Westfall Registration
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of Spouse or Guest(s) if planning to attend
Meeting Registration

Includes one ticket to Friday, June 7 business lunch and 6 hours of CE credit
Please select one of the following:

Member Registration Guest (parent, spouse, or child of active member) Guest (orthodontist accompanied by a member) Retired Member 2018 Graduate Current Resident Full time UT faculty
Please select one of the following:

Member Registration Guest (parent, spouse, or child of active member) Guest (orthodontist accompanied by a member) Retired Member 2018 Graduate Current Resident Full time UT faculty
Friday Night Backyard Bash

This year we are changing up the Friday night event. Join us Friday June 7 from 6:30-9:00 for a casual meal near the pool. There will be an open bar, face painting, and baloon artists.
Adults Attending ($25 each)
Children 12 And Under Attending ($25 each)
Ages of Children Attending
Please list any dietary restrictions
Golf Tournament

The tournament will be held Saturday June 8 from 12:00-6:00 and is $225 per golfer. Registration fee includes green fees, cart, and boxed lunch.
How many golfers in your party?
Do you have any pairing requests?
Total
Total Registration Fee

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USD Your total will be charged via PayPal on the following screen. After completing the payment process you will receive an email receipt and a list of your registration selections.
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