Registration

Meal Choices

The cost of the meeting and meal is $35.00 and your choice for entrée is Chicken or Beef

Vegetarian plates are available.

  • Please select meal choice on reservation form
  • Return by May 9, 2018
  • For late registration, please contact Ginger at   256-426-8848 or email at gingerfinzel@comcast.net
  • Social at 6:00—6:30

 

Name_______________________________

Address _____________________________

Phone______________________________

AGD Number_________________________

Others Attending_________________________

_______________________________________

_______________________________________

Meal Choice

_____________ Beef

_____________ Chicken

 

Take a moment and fill out this form or send us an email.

Make checks payable to:

Huntsville-Madison County Dental Society

E-mail: gingerfinzel@comcast.net

Phone:  256-426-8848

 

Mail this form to:

Huntsville-Madison County Dental Society

PO Box 4816

Huntsville, AL 35815

 

Remember the deadline for registration!