Private Dinner: Attendee Registration

Study Club - Elite Smiles Dr Sanor Private Dinner 2026: Attendee Registration

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone/Mobile

Registration Type:

ADHA Member $0

Non-ADHA Member/Future ADHA Member $30

Dentist $30

Dental Assistant or Other Office Team Member $30

Event Volunteer (Enter your coupon at checkout) $30

Disclosure

ADHA Member # (if Nonmember, dentist, DA, etc. please write none)

State and License # (if student, please write "Student")

Will you require a vegetarian or gluten-free meal option?

Yes - Vegetarian

Yes - Gluten-free

Processing Fees 4% - not eligible for refund.

Coupon

Apply Coupon

All requests for refunds must be made in writing to web@okdha.org. Refunds will be considered until 2 weeks prior to event, after that no refunds can be issued. Processing Fees will not be refunded. Thank you for your understanding.

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Private Dinner: Attendee Registration

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