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Register for Wasted Days

Please fill out our meeting registration form!

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Name to appear on Badge/Nametag
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Attending Staff Members (Badge names will come from first name)
Name & Position
Name & Position
Name & Position
Name & Position
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Name & Position
Name & Position
Name & Position
Name & Position
Name & Position
Name & Position
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Total # of persons attending:
# of attendees attending Friday night dinner:
# of guests attending Friday night dinner at $100 each:
Miscellaneous:
In case of an emergency at the meeting, please contact this person:
Phone:
The organization reserves the right to substitute lecturers or to cancel or reschedule sessions due to low enrollment or other unforeseen circumstances.
What aspect of this meeting is of most interest to you?General Topic
Location
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Networking
Acquiring CE Units
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Details:
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Are there any special accommodations you need to make your conference experience more comfortable? (i.e., hearing assistance, accessibility, diet considerations)
Where did you learn about this course?
Details about your referral?
Dates of course for which you are registering
Elite Code, if any
# of dentists at $1895
# of team members at $695
Total Registration Cost
Credit Card
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Cancellation Policy: Full refund less a $50 handling charge will be given if you cancel in writing 30 days prior to the opening of the meeting. No refund will be made for cancellations after this date.

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Our Newest  Event:

Wasted Days and Sleepless Nights

 Newly Registered Speakers:

Rubin Cheek

Fred Weiner

J.A. Shapira

 

 
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"The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn."
   -- Alvin Toffler

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THIS MONTH'S  POLL

Phones and Pagers at Meetings

When asked to turn off your phones and pagers at a meeting, what action do you take?
I turn it off
I put it on vibrate
I leave it on ring
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