For a small convenience fee you can register online at
Or mail this registration form with check or money order to:
Anita Herzog, Southern Component Utah Dental Hygiene Association
66 E 3930 S
Washington UT 84780
Checks payable to: Southern Component of UDHA
Participant Name______________________________ ADHA number_____________
All day registration, breakfast and lunch included Member $ 60 Non-member $ 130
Half day registration, no meals included Member $ 35 Non-member $ 70
Student registration, meals included $ 25
Please bring this registration form with you at sign in.
Event will be located on the northeast corner of the Recreation Center in the banquet room.