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IF YOU ARE A PAID MEMBER OF THE ADA, PDA AND SECOND DISTRICT, PLEASE MAKE THE APPROPRIATE SELECTION BELOW.

(NOTE: To qualify for Second District Membership you must practice in Bucks, Chester, Delaware, Lehigh, Montgomery or Northampton Counties). YOUR 2018 MEMBERSHIP DUES MUST BE PAID BY FEBRUARY 14th TO BE ELIGIBLE TO PRE-REGISTER. ON-SITE REGISTRANTS MUST PAY THEIR DUES PRIOR TO THE START OF THE CONFERENCE.

****SECOND DISTRICT PAID MEMBER (with offices in Bucks, Chester, Delaware, Lehigh, Montgomery or Northampton Counties)

First Name: *
Last Name: *
Email: *
Reg Category: *	Purchase two full days of courses and receive a Free Night at the Valley Forge Radisson Hotel plus 2 buffet lunch tickets… $520.00 per person. HANDS-ON Courses not included in this package. SEE REGISTRATION FORM FOR DETAILS

I would like to:

	Create a new registration, this is my first visit for this event.
	I am already registered for this event, I need to access my information.