Where: McCormick Place West Hall, Room 181A

When: (2Sessions*): FRIDAY, FEBRUARY 24, 2012 Session1:9AM–Noon Session2:1:30PM–4:30PM *Differenttopicswillbecovered

ineachsession.

see next page for registration information

Visit us at:

www.dentalassistant.org

CourseModerator:Jennifer K. Blake, CDA, EFDA, MADAA

JenBlakehasbeenamemberofthedentalteamforover35years.Shehasbeenaclinicalassistant,educator,andispastpresidentofthe

AmericanDentalAssistantsAssociation.CurrentlysheisservingasADAADirectorofEducationand

ProfessionalRelations.

PRE–REGISTRATION DEADLINEFriday, February 17, 2012

Back by Popular Demand!Featuring New Products & New ManufacturersHave fun while you learn in this hands-on small group experience.

Share ideas with other dental assistants in your group while you are introduced to new products and techniques that will benefit your practice.

You will come away energized with new ideas, new colleagues and lots of prod-uct samples for your office.

PRE–REGISTRATIONisnotrequiredbuthighlyrecommended.PreregistrationbeginsNovember1,2011.Seatingwillbelimited.Don’t miss this opportunity!

147th Chicago Midwinter Meeting

ATTENDEES WILL BENEFIT FROM:• Productsamples,education,doorprizes,fellowshipandfun.

• 3CEUstobeearnedforeachsession.ADAAisdesignatedasanApprovedPACEProgramProviderbytheAcademyofGeneralDentistry.ThiscoursehasbeenapprovedforDANBCDEcredit.

Fees:$5 Per Session ADAA MembersMembers sign up for both sessions for $8!

$10 Per Session for E-Members & Non–MembersE-Members & Non-Members sign up for both sessions for $15(No refunds)

Learning in the Round

REGISTRATION INFORMATION Fees: ADAAMembers $5persession

Members sign up for both sessions for $8!Non–ADAAMembers $10persessionE-Members & Non-Members sign up for both sessions for $15(No refunds)

American Dental Assistants Association147th Chicago Midwinter MeetingMcCormick Place — West Hall, Room 181A

Anychangeinlocationwillbenotedintheon-siteprogramandintheregistrationmaterialssenttopre–registeredattendees.

Pre–Registration for ADAA Learning in the RoundDeadline: February 17, 2012Pre-registrationstronglyrecommended.Courseswillbeclosedoncemaximumregistrationhasbeenachieved.RegistrationforthiscourseisseparatefromCDSandishandledbyADAAonly.

Pre–Registration for CDS MeetingBothmembersandnon-memberswhowishtoregisterfortheCDSMeetingitself,includingadmissiontotheExhibitFloor,shouldfilloutCDSMeetingRegistrationformsandsubmitthemwithfee(ifany)toCDSasdirectedonhttp://www.cds.org/mwm/.Allofthosepre–registeredwiththeCDSwillreceivebadgesduringFebruaryinthemail.TheseregistrantsneedonlystopbytheChica-goDentalSocietyregistrationdesktopickupaplasticbadgeholderandMidwinterprogram.BadgesarenotrequiredforadmissiontoADAAcourses,butarerequiredforadmissiontotheexhibitfloor.

On–Site RegistrationOn–siteregistrationforcourseswilltakeplaceoutsidetheroominwhichcoursesarebeingpresentedandwillbehandledonafirst–come,first–servedbasisifspaceisavailable.Achargeof$10willbeaddedtothecoursefeeforADAAMembers,E-MembersandNon–members.Thoseregisteringon–siteforADAAcourseswillalsohavetoregisterattheCDSregistrationdeskiftheywishtoobtainabadgeandbadgeholder,requiredforadmissiontotheexhibitfloor,andtoobtainageneralprogram.ThereisnoCDSregistrationfeeformembersoftheIllinoisDentalAssistantsAssociation.IllinoisADAAmembers,besuretobringyourmembershipcardforfreeCDSreg-istrationon–site.Allotherassistants,evenifmembersofotherADAAstatecomponents,mustpayaregistrationfeetoCDSforbadgeandbadgeholder.

Continuing Education CreditThecoursesofferedbyADAAatthismeetingareapprovedforCECreditwiththeDentalAssistingNationalBoardandmoststateagen-ciesrequiringdentalassistingcontinuingeducation.(Checkwithyourstateboardifyouhaveanyquestions.)

ADAAisanAGD–ApprovedNationalSponsorFAGD/MAGDCredit04/10/1992to05/31/2015ProviderID#217389

CDS-2012

ByFebruary 17, 2012,returnthisregistrationto:

ADAAMidwinterMeeting35EastWackerDrive,Suite1730ChicagoIL60601–2211Fax:312–541–1496—Notelephoneregistration

Returnformwithcheck,moneyorderorcreditcardinformation.Wewillnotbillyou.Faxedformsmustincludecreditcardinforma-tion.*ADAAmembersshouldincludeaphotocopyoftheircurrentmembershipcardwithfaxedormailedregistration.

RegistrationisalsoavailableonlineNov. 1, 2011atwww.dentalassistant.org.

Registration limited — sign up early.Youwillbenotifiedbye–mailofyourregistration.

Learning in the Round – February 24, 2012

PLEASEPRINTStatus(CircleOne) ADAAMember E-Member Non-Member

�2/24AMsession �2/24PMsession9:00–Noon 1:30–4:30PM

ADAAMembershipNumber

Name

HomeAddress

City/State/Zip

E–mail(required)E=mailneededtosendconfirmation.

DaytimePhone:

Paymentmadeby:

�Check �MasterCard �MoneyOrder �Visa

ChargeCardAccountInformation________–________–________–________

Expires____/____(month/year)

CardholderNameCardholderAddress

CardholderSignature

TotalAmountEnclosed:$ILresidentsmustadd10%salestax.

Thisform,tobereturnedtoADAA,registersyouforADAAeduca-tiononly.YoumustregisterwithCDSbymailoron–sitetoreceiveabadgeandaprogramandaccesstotheexhibithall.

Youwillbenotifiediftheclassisfull.NO REFUNDS.

Seatnotguaranteed10minutesafterstartofprogram.