Excellence in Orthodontics and Dentofacial Orthopeadics
P.O.Box6151UNSWSydney,NSW1466Sydney,AustraliaPh:+61293988338E-mail:[email protected]
REGISTRATIONFORMFOR3YEARORTHODONTICMINIRESIDENCYPROGRAMME2017-2019
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&Clinicalsession(3daysintotal)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]),fax(0293145936)orpost(P.O.6151,UNSWSydneyNSW1466)
Excellence in Orthodontics and Dentofacial Orthopeadics
P.O.Box6151UNSWSydney,NSW1466Sydney,AustraliaPh:+61293988338E-mail:[email protected]
REGISTRATIONFORMFOR3YEARORTHODONTICMINIRESIDENCYPROGRAMME2017-2019
2017
CourseI 18-19 March 2017
OrthodonticDiagnosis
CourseII 6-7 May 2017 Orthodontic Treatment Planning and Cephalometrics
CourseIII 15-16 July 2017 Mixed Dentition Treatment and Myofunctional Therapy
CourseIV 16-17 September 2017 ClassIICorrection
CourseV 28-29 October 2017 ClassIIICorrection
CourseVI 9-10 December 2017 StraightwireMechanicsandPSLTechniques
2018 CourseVII 10-11 February 2018 HighAngleMalocclusions
CourseVIII 14-15 April 2018 Perio/OrthoInterface
CourseIX 2-3 June 2018 OrthodonticBiomechanics
CourseX 11-12 August 2018 Surgical Orthodontics/Skeletal Anchorage/ENT
CourseXI 13-14 October 2018 LingualAppliances
CourseXII 24-25 November 2018 ManagementofTMD/Bruxism
2019 CourseXIII 16-17 February 2019 Digital Smile Design/CosmeticInjectables
CourseXIV 6-7 April 2019 Accelerated Orthodontics
CourseXV 1-2 June 2019 Clear AlignersandCombinationTreatment
CourseXVI 10-11 August 2019 The Orthodontic/Restorative Interface
CourseXVII 12-13 October 2019 Advanced Biomechanics
CourseXVIII 1-2 December 2019 Case Finishing and Retention
**NOTE**:ALLDATESARESUBJECTTOCHANGE.Duringthecourse,therecouldbesomechangestothevenueforclinicalday.Shouldthishappen,youwillbenotifiedviaemail,wellinadvance,regardingthevenue/datechange.
Pleasetickonetospecifywhichclinicaldayyouwouldprefertoattend.Pleasenotetherearelimitedspacesavailableforeachclinicaldayoncespacesarefull,wewillnotbeabletoaccommodateyourchoice.
Thursday Friday Monday Tuesdays
Pleasenoteonceyouhavemadeyourchoiceyouwillnotbeallowedtochangeyourdayunlessyouareabletofindsomeonetoswapyourdaywith.
