ASDA District 2 Pre-Dental Open House
DATE: Saturday September 23, 2017
TIME: 8:30am-3pm
LOCATION: New York College of Dentistry 345 E 24th St New York, NY
ADMISSION: $25 (ASDA members); $35 (non-ASDA members)
   *breakfast, lunch & goodie bag included

NOTE: Payment must be received by SUNDAY SEPT. 17TH at 11:59PM, otherwise a $5 late fee will be charged. This payment is non-refundable. An additional $10 fee will be applied if payment is received on the day of the program without advance notice or pre-authorization to do so.

Contact us: ker415@nyu.edu; poc2103@cumc.columbia.edu
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Name *
Email *
Are you an ASDA pre-dental member? *
If yes, what is your ASDA/ADA Member #?
This information can be found by logging in to your account on www.asdanet.org & clicking on "MyASDA" and then clicking on "Update Profile." Your ASDA/ADA member # will then appear at the top. This is required to receive the $25 fee.
College/University (if applicable)
If you are currently enrolled in a bachelor's or master's program please specify which college or university you are currently attending & the state in which it is located. Example: Syracuse University (New York)
Anticipated graduation year from current program (if applicable)
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Method of Payment *
If you send a check please make payable to "ASDA District 2" and send to Priscilla Chan 50 Haven #B111 New York, NY 10032. Once your money is received you will receive an email confirming that your payment has been received and your registration is complete.
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