Saturday 3 November 2012 Grand Hotel Palace 305-307 Monastiriou str, Thessaloniki

Международен семинар по Ортодонтия

Registration
By e-mail and/or Internet only, at info@orthoshop.gr
You will receive acknowledgement of your enrollment
by email.
Registration fee must accompany application.
Registrations on the day of the course will be accepted
on a space available basis.

Tuition/Fees
Orthodontic Society
of Northern Greece Members: free
Non-Members: 70 Euros
paid in advance by credit card
(lunch buffet and coffee breaks included)
Make your registration until 27 th September 2012
Registration form
Name: ____________________________________
Mailing Address:____________________________
City, State, Zip: _____________________________
Email: ____________________________________
Day phone: ______________ Fax:______________
Title: DDS, DMD, DH, DA, Offi ce Staff
Course: INTERNATIONAL SEMINAR &
1st BENEFIT- BENEPLATE USERS MEETING IN
GREECE
Pay by: Check, Visa, MC, Discover, American EX
Card number: ______________________________
Exp date: ______________ Security Code:______
Cardholder's Signature: ______________________
Make checks payable to:

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