2025 ANDA Membership and Convention Registration

To complete your 2025 ANDA MEMBERSHIP AND CONVENTION REGISTRATION, complete the form below. You can join or renew your membership with ANDA, under the Membership tab, then register for the convention under the Convention section.

For assistance, contact ANDA Member Services at ycwill@live.com or gdliving57@gmail.com
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*Registration is required to receive Convention Badges for access to convention areas*

Your Information

First Name

Last Name

Spouses First Name

Spouses Last Name

Phone

Street Address Line 1

Street Address Line 2

City

State

Zip Code

ANDA Dues/ Registration/ Fees

All Dental Spouses, Convention Guests and Children must register through ANDA. Members of NDA (Dentists must register with NDA) or other auxiliaries must register with their perspective group.

Dentist Spouse - $75.00 Quantity

Guests - $75.00 Quantity

Children/Teen - $25.00 Quantity

College Students - $25.00 Quantity

Scholarship Donation - $25.00+ Dollar Amount

Community Service Donation - $25.00+ Dollar Amount

Breakfast with ANDA - $35.00 Quantity

ANDA Happy Hour with Friends (Appetizers Provided by ANDA. Beverages paid by Guest.)

Would You Like To Attend

YesNo

Guests, Children, Teens, Student Names

Name

Age (if under 18)

Name

Age (if under 18)

Name

Age (if under 18)

Name

Age (if under 18)

Total

Spouse Amount:

Guest Amount:

Student Amount:

Breakfast Amount:

Total Amount Due Today:

Payment Information

Payment Method

Credit CardCheck

Name on Card

Billing Email

Card Number

Code

Please make checks payable to: ANDA (Auxiliary to the National Dental Association) Return registration form with payment to: Mrs. Yolanda Williams 20385 Brookshire Dr., Southfield, MI 48076 Email: gdliving57@gmail.com

Edit To complete your 2025 ANDA MEMBERSHIP AND CONVENTION REGISTRATION, complete the form below. You can join or renew your membership to the ANDA under the Membership tab, then register for the convention under the Convention section.

For assistance, contact ANDA Member Services at ycwill@live.com or gdvliving57@gmail.com.

*Registration is required to receive Convention Badges for access to convention areas*

We look forward to your participation with ANDA ! this text

National Dental Association