~ ANNUAL  SESSION  2010 REGISTRATION ~
Location of Annual Session 09

MDHA 82nd Annual Session  *   April 23, 2010  *  MSU Campus
Kahlmus Auditorium  * 1000 Hwy 19 North,  Meridian, MS 39307
PRINT BROCHURE WITH DETAILED AGENDA

2 WAYS TO REGISTER:

1) Register Online Below and
Pay Online.
Fill out form once for each person you are registering for. You may pay for multiple attendees at once with PayPal Account, or with Bank or Credit Card. After registering, go to  payment page.

2) By Regular Mail and Check
or money order. (Make check
out to MDHA) Just print and mail this brochure along with your
check to:
Linda Zakkak
MDHA
38 Shoreline Lane
Gulfport, MS 39503

ONLINE REGISTRATION

After you register, a payment link at the bottom of this page will
take you to the payment page.

PROCESS: (Please Read)
  • You may register here for multiple attendees. Simply fill out form below once for each attendee. (Be sure to submit the form each time you complete a registration.)
  • You will receive an email confirmation of each registration you complete.
  • Button at bottom of form will take you to payment page where you may pay with PayPal, bank or credit card.
  • You can pay for single or multiple attendees with one transaction at PayPal.
Attendee Name *
Address *
City/State/Zip *
E-mail *
Phone *
ADHA Membership #
Name on Credit Card *
Continental Breakfast 7:45 am - 8:00 am
                 
* Required
After 4/9/10 registration costs for each group will cost $10 more.
Thank you for completing your registration.

Mississippi Dental Hygienists' Association    P O Box 377      Merigold, MS  38759    Phone: 662-719-8595   EMAIL

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