of the North Carolina Dental Society

invites you to the

 Mid-Winter Meeting

Saturday, February 22, 2014

Click for Crowne Plaza Hickory

1385 Lenoir Rhyne Blvd, SE

Hickory, NC 28602

Please check the Meeting Flier for important changes 

    Mid-Winter Meeting Flier and (Mail) Paper Registration Form

First Year Dentist Online Registration

 

Click for Certificate of the Sec of 1st District Dental Society 

    Click for 1st District Constitution and Bylaws

Required field(s) are indicated by an *.


Dentist Registration Only

PO Box or Street
Please include area code


Registration Fees: includes Meeting Fees, Continental Breakfast and Buffet Lunch



Names of Staff and Spouse Attending



Please charge this total to my credit card.
* Name Name as it appears on the credit card
Type
* Number Credit Card Number
* Card Security Code Card Security Code
* Exp. Date mm/yyyy
To complete the registration you MUST press the Submit button. Print this form for your records.