Click HERE for the PDF Registration Form.

2019 ANNUAL MEETING

Friday, March 15, 2019

Harris Conference Center

DATE: Friday, March 15, 2019
TIME: 7:30 a.m. - 1 p.m.
PLACE: Dentsply Sirona Academy
13320 Ballantyne Corporate Place, Charlotte NC 28277
Registration Deadline: Friday March 8 , 2019 
No refunds after Friday, March 8 , 2019
Registration Fee per person:  $199

Name:*
Title (ex: DDS, DMS, etc):
Degree:
Address:
Phone:
-
Fax:
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E-mail:*
Vegetarian Meal:
Special Dietary Needs:
Special Dietary Needs Notes:
Accessibility:
Accessibility: Please note accommodations needed to participate fully.:
Names of Attendees:*
Registrations: