Click HERE for the PDF Registration Form.

2018 ANNUAL MEETING

Friday, March 2, 2018

Harris Conference Center

DATE: Friday, March 2, 2018
TIME: 8 a.m. - 4 p.m.
PLACE: Harris Conference Center 3216 CPCC Harris Campus Drive (704) 330-4611
Registration Deadline: Friday February 23 , 2018
No refunds after Friday, February 23, 2018
Registration Fee per person:
*Received in CDS office by February 23 2018:
Dentist (members): $325         Staff: $225
Dentist (non-members): $375

Name:*
Title (ex: DDS, DMS, etc):
Degree:
Address:
Phone:
-
Fax:
-
E-mail:*
Vegetarian Meal:
Special Dietary Needs:
Special Dietary Needs Notes:
Accessibility:
Accessibility: Please note accommodations needed to participate fully.:
Name of additional Staff Attendee - #1:
Name of additional Staff Attendee - #2:
Name of additional Staff Attendee - #3:
Check your attendance choice(s):*