Spring Conference Registration

Step 1

* denotes required fields

Conference Rates ($100 added if you pay after March 22, 2013)
Rates include: seminars, meals and breaks

Registration fees are fully refundable prior to March 22, 2013. 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

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

Name Prefix:
*First Name:
*Last Name:
Spouse First Name:
Children:
CA Name:
* Address:
* City:
* State:
* Zip:
* Phone:
Fax:
Email:

* Select One

$290 SDCA Member.(After March 22, 2013 $390)

$340 SDCA Member. and Spouse. (After March 22, 2013 $440)

$390 Non-member. (After March 22, 2013 $490)

$440 Non-member and Spouse. (After March 22, 2013 $540)

$200 New DC Licensed in 2011/2010. (After March 22, 2013 $300)

$250 New DC Licensed in 2011/2010 and Spouse. (After March 22, 2013 $350)

$150 New DC Licensed in 2012. (After March 22, 2013 $250)

$200 New DC Licensed in 2012 and Spouse. (After March 22, 2013 $300)

CA Certification (* Select One)

$150 CA Recertification - DC SDCA Member

$250 CA Recertification - DC Non-SDCA Member

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