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. 



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)



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
PO Box 1602, Cypress, TX 77429  E-mail: