House of Delegates RSVP 2023

Prefix

Name*

First Last

What first name would you like printed on your name badge?*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Phone*

Will you be attending the 2023 House of Delegates?*

Yes
No

Will your spouse/guest be accompanying you?*

Yes
No

If yes, what is your guest's name?

First Last

What is your district?*

Minneapolis District
Northeastern District
Northwestern District
Saint Paul District
Southeastern District
Southern District
Student District
West Central District
Invited Guest of the MDA

Please indicate the capacity you will be serving in the 2023 House of Delegates.*

The MDA is voting electronically. Will you have access to a computer or smartphone during the HOD meeting?*

Yes
No
Not applicable

Please RSVP for the following events by checking the boxes next to the events you plan to attend. Delegates and Alternate Delegates are required to attend the open forums. All other events are optional.*

Reception on Thursday, September 21, from 7 p.m. to 9 p.m.
Breakfast on Friday, September 22
Lunch on Friday, September 22

If your spouse/guest is attending, please check which events they will be attending.

Reception on Thursday, September 21, from 7 p.m. to 9 p.m.
Breakfast on Friday, September 22

Do you have any dietary restrictions?*

Yes
No

If yes, please indicate dietary restrictions.

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

Minnesota Dental Association

House of Delegates RSVP 2023

House of Delegates RSVP 2023

HOD Online RSVP 2023