AAID
Medicine and Pharmacology for the Dental Practice

Registration

March 18 - 19, 2011
Chicago, IL
ADA Headquarters Building

Earlybird Registration Deadline February 15, 2011

Deadline for registration: March 4, 2011
Registration is limited and is on a first-come, first-served basis. Sign up TODAY, either online or by fax or mail.

Contact Information (* = Required information)
* First Name:
* Last name:
Degree:
Address:
City:
State:
Zip:
* Phone:
Fax:
* Email:

Tuition
The course tuition includes continental breakfast and lunch each day.
AAID member: $1,550
Non-member: $2,050
Allied dental staff: $150

Method of Payment
VISA   MasterCard   Discover American Express
Card #:---
Expiration Date:
Security Code:

Cancellation and No-Shows
The fee, less a $100 administrative charge, is refundable if notice of cancellation is received at least fourteen (14) days before the course begins.