How to Register

How to Register
1. On-line www.scdaannualsession.com/registration
2. Fax your registration form (front & back) with credit card payment to 817-277-7616
3. Mail the registration form with payment to:
2010 SCDA Annual Session
c/o Custom Registration
2020 E. Randol Mill Road
Suite 307
Arlington, TX 76011
Questions?
Call 877-205-1943 between the hours of 8:00 am – 5:00 pm central time or email [email protected]
Special Needs:
If you require special assistance, please contact [email protected] as soon as possible in advance of the
meeting so appropriate arrangements can be made.
Alcohol Policy:
In South Carolina, the minimum age for the consumption of liquor, beer and wine is 21 years of age. SCDA's official policy is to respect the drinking age restrictions set by the jurisdiction where an event takes place.
Confirmation Packets:
Confirmation packets, to include badges, will be mailed to pre-registered conference attendees starting at the
end of March. If you do not receive yours or have changes, please contact our registration company at the
phone number or email address above. All registrations processed after April 20, will need to pick-up their
materials on-site.
Cancellations:
If you should have to cancel, refunds for registration will be made less a $25 administration fee upon receipt of
written request received by fax or email on or before March 26. No refunds will be issued after that date and all
refunds will be processed after the conference. Cancellation notices should be communicated to SCDA in writing by faxing the written notification to 803-750-1644, via e-mail to [email protected] or mailing written notification to
Deanna Slomzenski, SCDA, 120 Stonemark Lane, Columbia, SC 29210. If you have further questions regarding
the cancellation, please call Deanna Slomzenski toll free in SC at 1-800-327-2598 or outside SC at 803-750-2277.
Payment Section:
Registration Fee Total $______________
Session & Event Ticket Price Total $_________________
Total Charge $_________________
Check or Money Order (Payable to the South Carolina Dental Association)
Visa
MasterCard
Discover
AMX
Credit Card # _______________________________________ Exp. Date: _________ V Code* _____________
number found on the far right of the backside of VISA,
* 3-digit
MasterCard and Discover cards
4-digit number found on the front right side of American Express
Signature: _________________________________________________________________________________
Print Name : _______________________________________________________________________________
(as it appears on the credit card)
I. Registration – one form per person (please print or type)
Registration Type:______________________________________
* Registration fee includes admittance to the Thursday welcome reception & beach dance,
exhibit hall and most general sessions.
Registration Type
SCDA Member
Out-of-State ADA Member
ADA Non-Member Dentist
SCDLA Member, Military & Out-of-State CDT
SCDLA Non-Member
Hygienist
Dental Assistant
Business Assistant
Full-Time Faculty
Spouse of Dentist
Guest
MUSC Dental Student
Hygiene Student
Dental Assistant Student
SCDA or ADA Retired
Voluntary Gift to Sponsor Dental Student
By 3/26
150.00
250.00
450.00
125.00
250.00
50.00
50.00
50.00
Free
Free
Free
Free
Free
Free
Free
35.00
After 3/26
210.00
350.00
510.00
150.00
275.00
60.00
60.00
60.00
25.00
25.00
25.00
Free
Free
Free
Free
35.00
Registrant Name: _____________________________________________________________________________
Company/Name of Practice: ____________________________________________________________________
Address: ____________________________________________________________________________________
City: __________________________________________________ State: ___________ Zip: _________________
Phone: _________________________________________________ Fax: ________________________________
E–Mail: _____________________________________________________________________________________
By providing your email address, you grant SCDA permission to contact you via email regarding your
registration as well as to receive updates and/or promotional materials from this conference. Your e-mail
address will not be given to any third party. Photographs of the attendees may be used in future
publications including but not exclusive to the website, ads, invitations and brochures.
II. Ribbons Needed: (mark all that apply)
___Alternate ___Board Member ___Convention Committee ___DAD Volunteer ___Delegate
___ DenPac ___Designated Buyer___GKAS Volunteer ___Executive Committee
___ Faculty ___New Member ___ Palmetto Club ___Past President
___ Pinnacle Club ___Speaker ___Student Sponsor ___ Student
III. Accommodations:
Are you staying at the Kingston Plantation? Yes
No
IV. Session Registration & Special Events
Please indicate the sessions or events you plan to attend.
Thursday, April 29
7:30 am – 8:30 am
9 am – 12 pm
9:30 am – 12 pm
12 pm – 2 pm
2 pm – 5 pm
4 pm – 5 pm
5 pm – 6:30 pm
8 pm – 11 pm
T01
Past Presidents’ Breakfast
Prescription Drug Abuse & Meth Mouth - What's Cooking in Your Office
T02
SCDA House/General Membership Meeting
T03
T04 $35 SCDA Awards Luncheon
Recognizing and Reporting Abuse and Neglect - You and the Law
T05
Pharmacotherapy Review for Dentists: a Focus on Antibiotics and Narcotisc
T06
T07
SCDA Town Hall Meeting
T08
Welcome Reception in the Exhibit Hall
T09
Beach Dance - Featuring the Ninth Row Band
Friday, April 30
8 am – 12 pm
8:30 am – 11:30 am
9 am – 10:30 am
11:30 am – 1 pm
12 pm – 1 pm
1 pm – 5 pm
1 pm – 3 pm
2 pm – 4 pm
3 pm – 5 pm
5 pm – 6 pm
5 pm – 7 pm
6:30 pm – 9:30 pm
F01 $60 CPR Recertification (limited to 35)
Removable Prosthodontics - Increased Demand in the Modern World Sponsored by SCDLA
F02
Bread and Butter Adhesive and Esthetic Dentistry
F03
Teenagers - What Their Mouths are Telling You but They're Not:
F04
Practical Information on Teen Health Issues
Sponsored by Philips Sonicare
F05
Alliance Drop-in
F06 $30 Dental Team Luncheon with SCCDH
F07 $35 MUSC, ACD, ICD & PFA Luncheon
F08
SCDLA Members Business Meeting & Luncheon
F09 $60 CPR Certification (limited to 35)
Full Contour Zirconia Fabrication on Implant & Abutment Level Restorations
F10
Sponsored by ZirkonZahn USA
Bread and Butter Adhesive and Esthetic Dentistry (continued from AM session)
F11
Customized Care for Healthy Patients and a Healthy Practive Sponsored by Philips Sonicare
F12
Improve Productivity with Precise Digital Impressions
F13
Sponsored by 3M ESPE
F14
SC Society of Pediatric Dentistry General Meeting
F15
State Board Drop-In
F16
Pediatric Drop-In
F17
MUSC/New Dentist Drop-In
Sponsored by Patterson Dental Supply
F18
SCDAA Sun and Sand Social
F19
SCDLA Reception
F20 $40 Low Country Dinner and Social being held at the Historic Myrtle Beach Train Depot
Saturday, May 1
7:30 am – 9 am
8 am – 9 am
8 am – 9:30 am
9 am – 12 pm
9:15 am – 10:30 am
10 am – 12 am
12 pm – 2 pm
1 pm – 5:30 pm
1 pm – 4 pm
S01 $24 DenPac Breakfast
Updates to the South Carolina Medicaid Dental Progam
S02
Infection Control for the Dental Laboratory (lab registrants only) Sponsored by SCDLA
S03
S04
SCDAA Breakfast
S05 $25 OSHA Update for the Dental Office (all proceeds are dontated by Dr. Hook to MUSC)
Practical Laser Assisted Dentistry
S06
Sponsored by Biolase
Esthetic Solutions for Today and Tomorrow
S07
Sponsored by Ivoclar Vivadent
S08
DenPac Board Meeting
S09
SCDAA Business Meeting
S10
SCDLA Awards Luncheon ($30 for non-registered lab attendees)
S11 $120 Golf Tournament at Pine Lakes Country Club
The Essentials of Restoratively Driven Esthetic Implant Dentistry Sponsored by Astra Trech, Inc.
S12
Sunday, May 2
8 am – 12 pm
S13
SCDLA CDT Exam
Registrant Name: _____________________________________________________________________________