Spring Conference Registration

Step 1

* denotes required fields

Conference Rates ($100 added if you pay after April 9, 2010)
Rates include: seminars, meals and breaks

Registration fees are fully refundable prior to April 9, 2010. After that date, you must call for credit. Most CE seminars are deductible for doctors and staff. Check with your accountant.

There are multiple pages to this application and they are easy to navigate. Please fill this out entirely whether you are registering by Check or online.

Contact Information

DC Registrant's name that will appear on check or credit card

*DC's First Name:
*DC's Last Name:
Spouse First Name:
* Address:
* City:
* State:
* Zip:
* Phone:
Fax:
Email:

* Select One

$290.00 SDCA Member.(After April 9, 2010 $390.00)

$340.00 SDCA Member. and Spouse. (After April 9, 2010 $440.00)

$370.00 Non-member. (After April 9, 2010 $470.00)

$420.00 Non-member and Spouse. (After April 9, 2010 $520.00)

$200.00 New DC Licensed in 2007. (After April 9, 2010 $300.00)

$250.00 New DC Licensed in 2007 and Spouse. (After April 9, 2010 $350.00)

$150.00 New DC Licensed in 2008/2009. (After April 9, 2010 $250.00)

$200.00 New DC Licensed in 2008/2009 and Spouse. (After April 9, 2010 $300.00)

Select One

$600 36 Hours X-Ray Certification

$100 6 Hour X-Ray Re-certification

C-PAC Contribution (Voluntary, $200.00 suggested) C-PAC donations must be paid by personal check or credit card.

$30.00 SDCA Auxiliary Dues

$10.00 for 10 Auxiliary Raffle Tickets

$20.00 for 25 Auxiliary Raffle Tickets