Please fill out all of the above information and choose from the options~ please list ALL events you are planning to attend~After you have filled out the required information please hit submit and proceed to add the items to your shopping cart to proceed with payment. Only after your payment has been received will your registration be complete. Please note there is a $35 fee for registration after Sept 9th. Note: NO Confirmations and NO refunds
MDHA Scientific Session 2011 Online Registration Form
Payment for CEUs
Highlight ALL Events You Plan to Attend Below
Name
Address
City, St, Zip
Email
Phone #
ADHA #
