| Download LDHA 2010 Annual Session Registration Form or print form below |
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Lod Cook Alumni Center
3838 W. Lakeshore Drive
Baton Rouge, LA 70808 |
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**Please DO NOT go by the Postmarked Date** FEB. 11, is the deadline.
In order to register you must have:
1.) Printed and Enclosed registration marked the programs to be attended.
2) Enclose check or money order Payable to LDHA.
3.) Members of the ADHA must enclose a copy of your membership card for discount.
4.) Send to: LDHA (Danell Deen)
13606 King Henry Ave.
Baton Rouge, LA 70816
Questions may be sent by email to Danell Deen at danelld@hotmail.com
*All funds are non-refundable- NSF Check will be charged a $35.00 handling fee |
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| Friday, March 12th, 2010 7:00 – 8:00 AM Registration |
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ADHA Member |
Potential Member |
Student |
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Friday, March 12th
Tricia Osuna, RDH, BS, FAADH
(9:00A.M. - 12:00 P.M., 3 Clinical CE Hours)
Course description: What is it? How do I use it? Today’s dental products and treatment options
(Includes Continental Breakfast)
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_____ $50 |
_____ $75 |
_____ $25 |
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Friday, March 12th
Tricia Osuna, RDH, BS, FAADH
(2:00 P.M. – 5:00 P.M., 3 Clinical CE Hours)
Course description: “Save me ~ Save you! Ergonomics and effective patient care”
(Lunch included if attending all Friday programs)
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_____ $50 |
_____ $75 |
_____ $25 |
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Saturday, March 13, 2010
Ron Kimbrough Premier Dental Sponsor
(7:00:-8:00 A.M., 1 Clinical CE Hours)
Course Description: New Directions in Remineralization _____Complimentary_________$0
(Registration/ Includes Continental Breakfast) |
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Saturday, March 13th
Patti DiGangi, RDH BS
(9:00 A.M. – 12:00 P.M., 3 Clinical CE Hours)
Course Description: It's all Connected: Oral Health & Whole Body Wellness
(Includes Continental Breakfast) |
_____ $50 |
_____ $75 |
_____ $25 |
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EARLY BIRD SPECIAL!!
(Must Include All Programs, Received & Processed By insert deadline)
(Total 10 CE's) |
_____ $125 |
_____ $200 |
_____ $50 |
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| Name: (Last, First, MI) |
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| Email address:(You will receive an email confirmation as a receipt for your record when your registration has been processed) |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Phone: (Home) |
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| Phone: (Cell / Work) |
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ADHA/SADHA Member #:
(Please enclose a current copy of card with registration) |
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| Amount Enclosed/Check #: |
$_____________________________________________ |
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Please Register Early – Seating is limited and applications are taken on a first come, first serve basis.
There will be a $15.00 fee included with on-site registration, which will be allocated to the legislative fund.
There is a $35.00 banking fee for all NSF checks.
*All funds are non-refundable |
