The
Texas Registered
Dental Assistant Lapel Pin™
The
Texas RDA
Lapel Pin™:
$10.00 x _________ = ________________________
Shipping, per pin: $2.00 x
_________ = ________________________
Total
____________
Only
cashiers checks or money orders will be accepted for payment.
PERSONAL CHECKS CANNOT BE ACCEPTED!
Shipping
information (please print or type):
Name
___________________________________________________________
Address
__________________________________________________________
City,
State, Zip ____________________________________________________
E-Mail
Address ___________________________________________________
Daytime
Phone ___________________________________________________
Please
make checks payable to: TDAA
or Texas Dental
Assistants Association.
Print
and mail this form along with payment to:
(Photocopies
are accepted)
TDAA
c/o
Ronda V. Lane, CDA, RDA, BS
1130
Indy Court
Irving,
TX 75060
The
Texas Dental Assistants Association (TDAA) is a non-profit organization. Any
donations made from the sale of The
Texas Registered Dental Assistants Lapel Pin™
will be used toward the education
of Dental Assistants.
Texas
Dental Assistants Association ©
2113 Spur Court, Denton, TX 76210 E-mail: TDAA2002@aol.com