March 8, 2025 Dental Academy Registration Question Title * We are happy that you chose to attend this event.Please enter the following information to register for the Dental Academy to be held on Saturday, March 8, 2025. LAST Name * FIRST Name * Organization * Address: City/Town * State * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP * Email Address: * Phone Number: * Question Title * Please describe your work in providing oral health services? Dentist Registered Dental Hygienist Dental Assistant Oral Health Educator I do not provide direct oral health services Other (please specify) Question Title * Dental Continuing Education Credits will be made available upon completion of the conference evaluation. I will be applying for Dental Continuing Education Credits I will not be applying for Dental Continuing Education Credits You will receive an invoice by email for the registration fee. Payment can be made through Paypal.Participants: Continuing dental education credits issued for participation in the CDE activity may not apply toward license renewal in all states. It is the responsibility of each participant to verify the requirements of his/her state licensing boards. Marshall University School of Medicine Department of Dentistry & Oral Surgery is an ADA CERP recognized provider.This continuing education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP). ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at CCEPR | Commission for Continuing Education Provider Recognition (ada.org) Question Title * Please indicate your food preference for lunch (provided). Regular Vegetarian Other lunch type (please specify) Registration VerificationAfter clicking on the Submit Registration button, you will receive a Survey Monkey confirmation that your entry was successfully completed. As we get closer to the adademy, a complete agenda will be sent to the email address used for registration. Submit Registration