Annual SessionAnnual      Session


~ ANNUAL  SESSION  2011 REGISTRATION ~
Location of Annual Session 09

MDHA 83rd Annual Session  *   April 1, 2011   Oxford Conference Center  
102 Ed Perry Blvd *  Oxford, MS
38655
PRINT BROCHURE WITH DETAILED AGENDA

2 WAYS TO REGISTER & PAY:

1) Register Online Below
and
Pay Online.

Fill out form once for each person you register for. You may pay for multiple attendees at once with PayPal Account, Bank or Credit Card. After registering, go to  payment page and pay for registration.

2) By USPS Mail and Check
or money order. (Make check
out to MDHA)
Just print and mail this brochure along with check or money order to:
Linda Zakkak
MDHA
38 Shoreline Lane
Gulfport, MS 39503
ONLINE REGISTRATION
PROCESS:  YOU MUST REGISTER ONLINE BELOW BEFORE YOU PAY ONLINE.
  • Fill out form once for each attendee. (Be sure to submit the form each time you complete a registration.)
  • Press button at bottom of form. It 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 Address: *
Phone *
ADHA Membership #
Name on Credit Card *

* Required


 

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

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