NDA Annual Summer Meeting Registration

First Name

Last Name

Acronym

DDS
DMD
N/A

Society

Please enter your local society: NNDS, SNDS, NENDS, or N/A if you not a NDA member

For UNLV Dental Students, please use your .edu email.

Attending as:

NDA Board Member
ADA Delegate
ADA Alternate Delegate
Delegate (Society)
Alternate Delegate (Society)
Student Delegate
NDA Member
UNLV Dental Student
Nonmember
Other

Number of additional guests attending the NDA Annual Summer Meeting?

0
1
2
3 or more

NDA Annual Summer Meeting Guest (s) Full Name

Please enter your guest(s) name separated by commas if more than one. If none, please enter N/A.

Meeting and Event Registration - Please advise attendance for the activities below.

Thursday, June 16, 2022. NDA Executive Committee meeting. This is a Closed Meeting.

Executive Committee Meeting (Closed Meeting) 6:30-8:30pm

Friday, June 17, 2022 (Please select all that apply)

Breakfast at 8:00am - 9:00am
House of Delegates Meeting - 9:00am
House of Delegates Lunch - 12:00pm -1:00pm
NDA Dinner Yacht Cruise - 6:00pm - 9:00pm ($100 per person or $45 Per UNLV SDM Student. Student Tickets are limited)

Number of additional guests attending the NDA Dinner Yacht Cruise

0
1
2
3 or more

NDA Dinner Yacht Cruise Guest (s) Full Name

Please enter your guest(s) name separated by commas if more than one. If none, please enter N/A.

Saturday, June 18, 2022 (Please select all that apply).

Breakfast at 8am - 9:00am
House of Delegates Meeting - 9:00am
Executive Committee & Council Chairs Meeting - 2:30pm - 3:30pm

Please list any food allergies below.

If you have no food allergies, enter "N/A".

NDA Annual Summer Meeting Registration

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