Register for KADA + KAOMI 2022 Step1: Registration Name Gender Male Female Dental License No. Email Phone Practice Address Practice Type Private Corporate / Large Group Practice Community Health Academia / Dental School Size of Practice 1-5 Staff 6-10 Staff 11-25 Staff 26+ Staff Undergraduate School Dental School Specialty Years in Practice Years as an ADA Member What information(s) are you most interested in obtaining? Practice Management Clinical Techniques Work/Life Balance Corporate vs Private Practice Other Tell us about yourself! What are your interests outside of dentistry? Certification I certify the information I provided on and in connection with this form is true and correct to the best of my knowledge. I also understand that any false statements or deliberate omissions on this form may subject me to legal actions for fraudulent misrepresentation. SUBMIT STEP 1 Step2: Payment Includes one year of KADA membership and KAOMI 2022: REBOOT, REBUILD Registration. Price: $225 for 365 Days Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn’t Match I have read and agree to the Terms and Conditions* This site collects names, emails and other user information. I consent to the terms set forth in the Privacy Policy. No val Please fix the errors above
