Lake County Dental Hygienists' Society

CE Registration

Registration for Continuing Education Meeting

Please fill out the form below. Once you hit the submit button, a copy will be sent to our Secretary, Donna Arnston and you will be re-directed to the Home page of our website.

Please remember to arrive about 10-15 minutes before the meeting so we may start promptly on time as we usually have about 5 minutes of announcements before the meeting starts.  Please be courteous to the speaker and silence your cell phones.
  Thank you!!!

  Member of LCDHS Component #17 (FREE)

Member of IDHA/ADHA  - $15.00
       (Please note the component # in comments section)

Non-Member or Doctor and/or Staff - $40.00

Current Students (FREE)
        (Please note in the comments section which school you are attending
          & graduation date)
First Name:
Last Name:
Address Street 1:
City:
Zip Code: (5 digits)
State:
Email:
Phone:
Comments:

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