registration form for 3 year orthodontic mini … · excellence in orthodontics and dentofacial...
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Excellence in Orthodontics and Dentofacial Orthopeadics
P.O.Box6151UNSWSydney,NSW1466Sydney,AustraliaPh:+61293988338E-mail:[email protected]
REGISTRATIONFORMFOR3YEARORTHODONTICMINIRESIDENCYPROGRAMME2018-2020
SURNAME: ____ FIRSTNAME:
ADDRESS:
CITY: STATE: POSTCODE:
COUNTRY: PHONE:
EMAIL:
Howdidyouhearaboutourcourse?-Colleague AlumniInternet
Advert(pleasespecifynameofMagazine)___________________Other___________
PAYMENTMETHOD
VISA MASTERCARD BANKCARD AMEX
NAMEONCARD:
CARDNO.
EXPIRYDATE: CCV.NO.
OR-IHAVEENCLOSEDACHEQUEMADEPAYABLETOEODOFORTHEAMOUNTOF$ .
PAYMENT/FEESAllcoursesrequirea50%Deposittoholdyourplace.Percourse:AUD$2,500.00(inclGST)-IncludesTheory&TYPODONTsession(3daysintotal)(C1-6)Payfor1yearupfronttoreceive5%discount.Payfor2yearsupfrontandreceive10%discountPayfor3yearsupfrontandreceive15%discountCANCELLATIONPOLICYAllcancellationsmustbemade,inwritingviaemail,[email protected],orafailuretoattendthecourse,therewillbenorefundissued.Forallcancellations,anadministrationfeeof$100willbecharged.Cancellationsmade4weekspriortothecoursestartdatearerefundedinfull.*Cancellationsmadewithin2-4weeksofthecoursestartdatewillberefundedto50percent.*Cancellationsmadewithin1-2weeksofthecoursestartdatehaveanoptionofa25percentcreditontheaccount,tobeusedforfuturecourses,butthereisnorefund.**Iftheoriginalpaymentwasmadebycreditcard,thecreditcardtransactionfeecannotberefunded.
PleasesendthisformbacktoEODOviaemail([email protected]),orpost(P.O.6151,UNSWSydneyNSW1466)
Excellence in Orthodontics and Dentofacial Orthopeadics
P.O.Box6151UNSWSydney,NSW1466Sydney,AustraliaPh:+61293988338E-mail:[email protected]
REGISTRATIONFORMFOR3YEARORTHODONTICMINIRESIDENCYPROGRAMME2018-2020
2018
CourseI 24-25 February 2018
OrthodonticDiagnosisandTreatment Planning
CourseII 13-14 May 2018 Cephalometrics and Orthodontic Treatment Planning
CourseIII 30 June- 1 July 2018 MYOFUNCTIONAL THERAPY & PAEDIATRIC OSA: Treatments in Primary Dentition and Breaking Habits
CourseIV 28-29 July 2018 MIXEDDENTITIONTREATMENTS
CourseV 27-28 October 2018 STRAIGHTWIRE:BracketPlacementandArchWireProgression
CourseVI 8-9 December 2018 STRAIGHTWIRE:MechanicsandTroubleshooting
2019 CourseVII 9-10 February 2019 CLASS II CORRECTION
CourseVIII 20-21 April 2019 CLASSIIICORRECTION
CourseIX 29-30 June 2019 OrthodonticBiomechanics
CourseX 24-25 August 2019 TREATMENT OF EXCESS VERTICAL
DIMENSION CourseXI 19-20 October 2019 TREATMENTOFOVERCLOSEDVERTICAL
DIMENSION CourseXII 7-8 December 2019 PERIO/ORTHOINTERFACE
ACCELERATEDORTHODONTICS
2020 CourseXIII 8-9 February 2020 PROSTHO/ORTHO INTERFACE
DIGITAL SMILE DESIGN CourseXIV 11-12 April 2020 ENDO/ORTHO INTERFACE
TREATMENT OF TRAUMATIC INJURIES CourseXV 20-21 June 2020 AESTHETIC ORTHODONTCS/ADULT
ORTHODONTICS LINGUAL BRACES & CLEAR ALIGNERS COSMETIC INJECTABLES
CourseXVI 15-16 August 2020 TREATMENT OF OROFACIAL PAIN/TMD/BRUXISM
CourseXVII 17-18 October 2020 SURGICAL ORTHODONTICS & SKELETAL ANCHORAGE/ TADs
CourseXVIII 5-6 December 2020 Case Finishing and Retention**NOTE**:ALLDATESARESUBJECTTOCHANGE.Duringthecourse,therecouldbesomechangestothevenueforclinicalday.Shouldthishappen,youwillbenotifiedviaemail,wellinadvance,regardingthevenue/datechange.
PleasetickonetospecifywhichTYPODONTDAY(Course1-6)youwouldprefertoattend.Pleasenotetherearelimitedspacesavailableforeachtypodontdayoncespacesarefull,wewillnotbeabletoaccommodateyourchoice.
Friday Monday
Excellence in Orthodontics and Dentofacial Orthopeadics
P.O.Box6151UNSWSydney,NSW1466Sydney,AustraliaPh:+61293988338E-mail:[email protected]
Pleasenoteonceyouhavemadeyourchoiceyouwillnotbeallowedtochangeyourdayunlessyouareabletofindsomeonetoswapyourdaywith.