WDS - Winnipeg Dental Society

Event Registration

Note: Non-member pricing is $200 per lecture and $50 for staff attending.
Payment must be submitted to our office at least 7 days prior to the lecture.

First Name:
Last Name:
Meal Requested:	Yes No
Winnipeg Dental Society Member:	Yes No
MDA Unique Number:	- -
Phone Number:	( ) -
Email Address:
Name of Event Registering For:
Name(s) of Staff/Fellow Attendees:	1. Meal requested: Yes No 2. Meal requested: Yes No 3. Meal requested: Yes No
Enter the text as shown in the box below:	* Your computer must accept cookies

NOTE: Notice of AUTOMATIC confirmation will be sent by email.