Empire Conference Attended Registration Form NYDHA Empire Conference/Annual Session Registration Form November 6-8, 2026 – Hyatt Regency Long Island, Hauppauge NY Name(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code Phone Country Phone Number Email(Required) Is this your first conference? Yes No Choose Registration type below:Non-Member RDH* Postmarked by Oct. 1, $220 Postmarked after Oct. 1, $255 NYDHA Member RDH Postmarked by Oct. 1, $150 Postmarked after Oct. 1, $175 Dental Hygiene Student** Postmarked by Oct. 1, $30 Postmarked after Oct. 1, $50 * Not yet a member? Use the member rate if you join now ** Pre-registered student professional poster presentation participants are exempt from paying registration fee.Event registration: Please check the events you will attend. Conference Registration entitles your entry into CE courses, Exhibitors’ Hall on Friday and Saturday, Friday and Sunday a.m. House of Delegates meetings, Friday morning Candidates’ Forum and Reference Committee Testimony sessions, the Saturday Student Professional Poster Presentations, Friday and Saturday Silent Auction, and Sunday a.m. House Installa- tion of Officers and Directors.Untitled Course #1Friday12:30-3 p.m.2 CEConference Opening! The Latest on HPV and: Oral Cancer: What Dental Hygienists Need to Know Course #2Friday3:30-5:30 p.m.2 CEArtificial Intelligence for Assessing and Classifying Periodontal Disease Course #3Friday3:30-5:30 p.m.2 CEThe ‘Why” Behind Lasers in Hygiene Course #4Saturday8-10 a.m.2 CEPTSD in the Dental Setting: A Trauma-Informed Approach to Patient Care Course #5Saturday8-10 a.m.2 CEElevating Clinical Outcomes: Modern Instrumentation and Desiccation in Dental Hygiene Therapy Course #6Saturday10:30-11:30 a.m.1 CEStudent Professional Poster Presentations Course #7* Saturday12-2:30 p.m.2 CECurrent Issues in Dental Hygiene Policy and Scope of Practice—see below for special registration* Course #8Saturday3-5 p.m.2 CEReview of Oral-Systemic Lesions in Autoimmune Diseases Course #9Saturday3-5 p.m.2 CESpit Happens: What Saliva Says About Your Whole Body Health Select the event(s) you would like to attend Saturday, 12-2:30 p.m., Luncheon (Course #7-Current Issues), $ 45.00 Saturday, 7-10 p.m., President’s Dinner + New: An Interactive Mystery!, $ 55.00 Special Events Total Price: Total Please note dietary restrictions on this form or email exdir@nydha.org at least 2 weeks prior to the conference:Dietary RestrictionsIf you have a disability and require special assistance, please email exdir@nydha.org at least 2 weeks prior to the conference. Your badge and special events tickets will be in your registration packet. Please stop at Registration Desk when you arrive. Cancellation policy: Written notice of cancellation accepted if postmarked by Oct. 1, 2026. Written cancellations postmarked after Oct. 1 to Oct. 22 subject to a $30.00 processing fee. Sorry, cancellations after Oct. 23 cannot be honored.When you click on Submit, you will be taken to the PayPal website to complete your payment. You do not need to have a PayPal account. You may click on pay with Credit or Debit card to use either of those methods.