FOOTHILLS
DENTAL HYGIENISTS’ SOCIETY
A COMPONENT OF THE
8th
ANNUAL SYMPOSIUM
Our featured speakers this
year are Tracey Jacobs, BSDH, RDH and Linda Harvey,
There will be time to visit
with the exhibitors, lunch, receive door prizes, and lots of camaraderie and
learning. Registration will begin at
Pre-registration is necessary
for lunch due to limited seating. In the
past we have accommodated those who chose to register on-site. This will no longer be possible. We must have an accurate head count for
lunch no later than August 13th.
AFTER AUGUST (10th) ADD
$20.00
$60 ADHA MEMBERS $90 DENTISTS
$50 GDHA BOARD MEMBERS $60 DENTAL ASSISTANTS
$70 NON-MEMBERS $25 HYGIENE STUDENTS
THERE WILL BE A CANCELLATION FEE OF $25
DIRECTIONS:
Map enclosed.
FYI: THE
HOURS OF CE FOR YOUR 22 HOURS REQUIRED FOR LICENSURE
ENCLOSE CHECK TO:
FOOTHILLS DENTAL HYGIENISTS’ SOCIETY,
3823
CHEROKEE
Checks will be cashed after the symposium.
IF YOU WOULD LIKE CONFIRMATION MAILED TO YOU PLEASE
INCLUDE A SELF ADDRESSED / STAMPED
ENVELOPE
PLEASE PRINT OR TYPE:
DIETARY REQUIREMENTS:______________________________________________________________________________
NAME:_________________________________ADHA ID#_______________STATE LICENSE #_______________________
ADDRESS:______________________________________________________________________________________________
TELEPHONE(S)__________________________________________________________________________________________
E-
Please check one of the
following categories:
ADHA MEMBER___________ BOARD MEMBER_________ NON MEMBER__________
DENTIST____________ DENTAL ASSISTANT_______________ HYGIENE
STUDENT__________
CONTACT