REGISTRATION FORM
“Hazard Communication Training and Office Safety”
and Mini Convention
Diane Morgan and Marcella Oster
March 7, 2008
 9:00 a.m. - 4:00 p.m.
 Phone: (530) 527-6764

Red Bluff Community Center 1500 South Jackson St. Red Bluff, CA
Participants
D.D.S.
PHONE:
RDA

RDH
OTHER DHP
No refunds after March 5th.   Dentist Late fee $15 and Auxiliary late fee $10
( ) $125 per CDA/ADA member dentist. Lunch included.
( ) $ 55 per RDA/RDH/Other Dental Health Professional. Lunch included
( ) $225 per non-CDA/ADA member dentist. Lunch included
Total 4 units of C.E. credits
Method of Payment

[ ] Check




Credit Card
[ ] Visa [ ] MasterCard

Expiration Date: MM/YY

_____/______
Make payable to: NCDS
P.O. Box 9265
Red Bluff, CA 96080


Name of Cardholder (please print)
___________________________________________________

Card # [ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ]



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Comments

We are required to attend four courses every renewal period. The dental board requires 2 hours on infection control and 2 hours on the Dental Practice Act. We did these in June 2007 and we will repeat it in the 2008-2009 year. CAL-OSHA requires courses in Hazard Communication and injury and Illness Prevention. This is the first time we have presented that course. In addition, Sullivan Schein will present a mini convention during the breaks, at lunch and after. This is a wonderful opportunity to connect with many of our vendors in a relaxed and casual setting.