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DCIDA Walkin Registration


Please use this form to pay onsite by credit card.
 
Name
Email Address- for event contact only
Address
City
State
Zip Code
Name on Card
Card Number
Card Type
CVV Code
Expiration Month
Expiration Year (last two digits 2018 would be 18)
A 3.69% convenience fee has been added to the total cost.
Student  @ $51.00
Teacher/DDMD  @ $77.00
DCIDA Member  @ $155.00
Nonmember  @ $186.00
Form Total: $0.00
Payment by Credit card- please note a 3.69% fee has been added for this convenience.


 


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