icp & epa joint meeting registration brochure · 2019-06-20 · now that we, starting from 1st...

9
SEPTEMBER 4–7, 2019 | BEURS VAN BERLAGE Science and Art in Prosthetic Dentistry CONFERENCE TOPICS Science & Art in Advanced Prosthodontics, Esthetic Dentistry/Digital Technology, Multidisciplinary/ Maxillofacial, Graduate Student Case Presentations, Implant Prosthodontics, Fixed & Removable/ Occlusion/Temporomandibular Disorders, Advanced Biomaterials, Management/ Complications, Special Needs/Geriatrics, Biology in Prosthodontics ICP GLOBAL PARTNERS Conference Administration: RES Seminars 4425 Cass Street, Suite A San Diego, CA 92109 USA E-mail: [email protected] Tel: 1 858 270-1814 Fax: 1 858 272-7687 www.icp-conference.com AMSTERDAM, THE NETHERLANDS ICP & EPA JOINT MEETING 18 th Biennial Meeting 36 th Year of the ICP www.icp-org.com 43 rd Annual Meeting of the EPA www.epadental.org REGISTRATION BROCHURE

Upload: others

Post on 31-Mar-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

SEPTEMBER 4–7, 2019 | BEURS VAN BERLAGE

Science and Art in Prosthetic Dentistry

CONFERENCE TOPICSScience & Art in Advanced Prosthodontics, Esthetic

Dentistry/Digital Technology, Multidisciplinary/Maxillofacial, Graduate Student Case Presentations,

Implant Prosthodontics, Fixed & Removable/Occlusion/Temporomandibular Disorders, Advanced

Biomaterials, Management/ Complications, SpecialNeeds/Geriatrics, Biology in Prosthodontics

ICP GLOBAL PARTNERS

Conference Administration: RES Seminars4425 Cass Street, Suite A San Diego, CA 92109 USA E-mail: [email protected] Tel: 1 858 270-1814 Fax: 1 858 272-7687

www.icp-conference.com

AMSTERDAM, THE NETHERLANDSICP & EPA JOINT MEETING

18th Biennial Meeting36th Year of the ICPwww.icp-org.com

43rd Annual Meetingof the EPA

www.epadental.org

REGISTRATION BROCHURE

Page 2: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

NICO CREUGEURS

Radboud University Medical Center

Oral Function & Prosthetic Dentistry

Nijmegen, Gelderland Netherlands NL

NICOLA URSULA ZITZMANN

University of Basel

Department of Reconstructive Dentistry

Basel Switzerland

Greetings to all our ICP members!

Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP from Mario Bresciano and Brian Fitzpatrick, it is a good occasion to look back on their successful Presidency and to look forward to the coming period.

Mario Bresciano and Brian Fitzpatrick, heading their team of Officers and Counselors, did a lot of work behind the scenes and out of direct sight of the ICP membership. What stands out most are the implementation of new grants and prizes for young researchers and members of ICP interested in doing research, together with professionalized procedures to apply for these grants. Another big issue was the update of standard operating procedures for the ICP board, which intensified the professionalization of the organization. Speaking of professionalization, we take a moment to reflect on the retirement of Eben Yancy, who as director of RES, was responsible for many years as the professional back-up of ICP. Although we have full trust in his committed successor Lynn Reeves, the ICP will miss his wisdom and engagement. Eben is owed ICP’s gratitude for all the work he has done for the College.

Most visible in the past two years was, of course, our bi-annual meeting in Santiago, Chili. It was the first occasion that the ICP held a conference in South America. The Scientific Program Committee, headed by Dr. Dean Morton on behalf of the ICP, and Dr. Eugenio Neito Grez on behalf of our local partner Sociedad de Protesis y Rehabilitacion Oral de Chile (SPROCh) – composed a program that addressed mainly two topics: one was the role and use of digital technologies in prosthodontics, the other was focusing on providing simple and minimal invasive treatment interventions to improve patients’ oral health-related quality of life. These two topics suggest covering two ends of the prosthodontic spectrum, but were brought under the conference theme of “Less is More“ in a very natural way as belonging together. Besides an interesting scientific program, the organizers provided us with excellent social outings and activities.

Usually, the even years show a quieter international scientific presence of ICP, but in 2018, ICP will participate in a combined scientific conference in conjunction with the Italian Academy of Prosthetic Dentistry (AIOP). ICP accepted an invitation of AIOP to participate in a two-day congress on Occlusion, Treatment Planning and Full-Arch on Implants in Riccione, Italy from April 13th to 15th, 2018. Another important activity, in which ICP is involved, is the Young Prosthodontic Educators workshop that will be held in Karlsruhe, Germany in October 2018. This initiative of the Chief Editor of the International Journal of Prosthodontics Dr. George Zarb, who chairs this workshop together with the director of the Dental Academy for Continuing Professional Development in Karlsruhe, Dr. Winfred Walther, is supported in part by the ICP, as proof of its engagement in not only research but also in educational matters. Through the Education Grants program, the ICP provides a portion of the financial support required for this unique workshop, which allows talented young prosthodontic educators to work together with a faculty of renowned senior prosthodontic scholars from all over the globe.

In 2018 your team comprising the Co-Presidents, Scientific Program Chairs, related Committees and RES, will be working diligently to continue to place the essential pieces together as we head toward the 18th International ICP Biennial Meeting, to be held together with the European Prosthodontic Association (EPA) in September 2019 in Amsterdam, the Netherlands.

Yours Sincerely, Dr. Nico Creugers and Dr. Nicola Ursula ZitzmannCo-Presidents of the ICP

Conference OverviewThe conference program will take place over 2 1/2 days and has the special advantage of a joint meeting with the European Prosthodontic Association (EPA). Presentations will be made by keynote speakers followed by short oral abstract submissions. The conference days will consist of both plenary and concurrent oral lecture sessions and poster presentations. Our 2019 Poster Session will be combined with the exhibit reception to further maximize sponsor exposure and networking amongst the delegates. The conference will also offer additional elective events, such as the ICP-EPA reception and banquet and an unforgettable social outing that you will not want to miss!

ICP PRESIDENTIAL MESSAGE

2 3

KAZUYOSHI BABA, DDS, PhD

Professor and Chair

Department of Prosthodontics

Showa University, Tokyo

PROGRAM CO-CHAIR

DAVID CHVARTSZAID, DDS, MSC (PROSTHO), MSC (PERIO), FRCD (C)

University of Toronto

Graduate Program Director, Prosthodontics

Assistant Professor, Faculty of Dentistry

Toronto, ON Canada

PROGRAM CO-CHAIR

KHEE HIAN PHOA, DDS, MaxilloFacial Prosthodontist, Restorative Dentist, EPA Specialist in Prosthodontics.

Leiden University Medical CenterDept. Maxillofacial Surgery and Maxillofacial Prosthodontics

GP Phoa-Kleinrijk Rotterdam, The Netherlands

PROGRAM CO-CHAIR

Page 3: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

CONFERENCE VENUE

3

ICP ADMINISTRATION

RES Seminars4425 Cass Street, Suite A

San Diego, CA 92109 USATel: 1 858 270 1814Fax: 1 858 272 7687

E-mail: [email protected]: www.icp-org.com

Please contact the ICP Conference Administration forfurther instructions

We’ve developed a one-stop-shop for our prosthodontic

colleagues to learn the latest information,

treatments and products available.

Our exhibit floor gives our delegates an intimate environment

to meet with your industry

representatives, and participate

in product demonstrations.

The Beurs van Berlage is a building on the Damrak, in the centre of Amsterdam. It was designed as a commodity exchange by architect Hendrik Petrus Berlage and constructed between 1896 and 1903.

The 18th Biennial Meeting of the ICP and the 43rd Annual Meeting of the the European Prosthodontic Association (EPA) will be held at the Beurs van Berlage, the premier convention venue in Amsterdam over the dates of September 4-7, 2019. Our agenda will bring together leaders in prosthodontics from around the world. The city of Amsterdam will provide an outstanding venue for for social and professional networking.

Amsterdam, The NetherlandsAmsterdam is one of the greatest small cities in the world. From its canals, to its world-famous museums and historical sights, it is one of the most unique cities in Europe. Known for its tolerance and diversity, Amsterdam has all of the advantages of a big city: rich culture, lively nightlife, international cuisine and great transportation – but is also quiet, with serene parks, squares and open spaces toenjoy throughout the city.

Hotel ReservationsThe ICP/EPA 2019 Joint Meeting will be held at the Beurs van Berlage Amsterdam Conference Center. This is located in the heart of Amsterdam. We have arranged for four different hotel options within walking distance of the conference venue for the attendees to select from. The following hotels have been specially selected for the ICP/EPA 2019 Joint Meeting.

DoubleTree by Hilton Hotel Amsterdam Centraal Station

Renaissance Amsterdam Hotel

Kimpton De Witt Amsterdam

NH Collection Amsterdam Grand Hotel Krasnapolsky

Please do not delay... make your reservations early! Link to hotel information.

CONTACT DETAILS

Would you need a room on a date that is currently not available? Or do you have other questions? Please contact the Conference Services department of the Beurs van Berlage at [email protected] or +31 (0)20 530 41 37

Rooms are limited and based on availability.

Page 4: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

18TH ICP BIENNIAL MEETING 43RD EPA ANNUAL MEETING

PROGRAM SCHEDULE

Wednesday, September 4 09:00 - 17:00 Exhibit Set-up17:00 - 18:30 Welcome Reception- Exhibit Area REGISTRATION OPEN 18:30 - 20:00 YPE Reunion (Invitation only- Past YPE Delegates)

Thursday, September 5 09:00 - 12:00 Focus Session- Keynote Presentations 09:00 - 09:30 Oxford Lecture10:00 - 10:45 AM Coffee Break- Exhibit Review12:00 - 13:30 Conference Lunch- Exhibit Review13:30 - 17:30 Concurrent Sessions15:30 - 16:15 PM Coffee Break- Exhibit Review17:30 Session Adjourns17:45 - 19:45 Poster Session & Exhibit Reception

Friday, September 6 09:00 - 12:30 Concurrent Sessions 10:30 - 11:15 AM Coffee Break- Exhibit Review12:30 - 14:30 Conference Lunch- Exhibit Review14:30 - 17:00 Concurrent Sessions17:00 Session Adjourns19:30 EPA/ICP Reception and Banquet

Saturday, September 7 09:00 - 12:15 Focus Session- Keynote Presentations10:00 - 10:45 AM Coffee Break- Exhibit Review12:00 Announcements & Awards12:15 Meeting Adjourns15:00-20:00 Group Networking Outing

Amsterdam, The Netherlands September 4-7, 2019Visit the world-famous 17th century capital of Holland. Enjoy the historic buildings, beautiful museums, and pleasant ambiance. Go for a boat tour on the canals, stroll through Vondelpark, and go shopping in the inner city. Amsterdam is a unique city!

4

CONFERENCE TOPICSScience & Art in Advanced Prosthodontics, Esthetic Dentistry/Digital Technology, Multidisciplinary/Maxillofacial, Graduate Student Case Presentations, Implant Prosthodontics, Fixed & Removable/Occlusion/Temporomandibular Disorders, Advanced Biomaterials, Management/Complications, Special Needs/Geriatrics, Biology in Prosthodontics

Program times are subject to change. Visit the ICP Conference website

for updated program information & details

www.icp-conference.com

Page 5: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

ICP OFFICERS & BOARD OF COUNCILORS Dr. Marcio Grossi

ICP PRESIDENTSDr. Nico Creugers

Dr. Nicola Ursula Zitzmann

VICE PRESIDENTSDr. Jung-Suk Han

Dr. Sreenivas Koka

SECRETARY Dr. David Bartlett

TREASURER Dr. Dale Howes

Conference Member BenefitsWe encourage our members to remain active and appreciate their support and dedication. Dues must be paid in full if registering for our meeting as a member. Members with dues in arrears may register at the non–member fee.

The International Journal of ProsthodonticsThe official journal of the ICP . . . a fantastic bargain!

ICP constituent and affiliate members receive a year’s subscription to the IJP included in your annual dues payment. ICP members are offered discounted conference fees and encouraged to submit abstracts. Take the opportunity to become a member TODAY! Review our organization and apply for membership on-line at: www.icp-org.com

Graduate Student Treatment Planning SessionWe are happy to announce that the ICP will once again incorporate a Graduate Student Treatment Planning Session.

This will consist of 15-minute presentations of case-specific treatment plans, treatment sequence and outcomes. The emphasis will be on the decision-making process involved in arriving at a diagnosis and appropriate treatment plan, taking into account the best available evidence.

BOARD OF COUNCILORSDr. Limor Avivi-Arber

Dr. Kazuyoshi Baba

Dr. James Dudley

Dr. David Felton

Dr. Marcio Grossi

Dr. Xinquan Jiang

Dr. Carlos Parra

Dr. Ami Smidt

RECENT PASTPRESIDENTS Dr. Mario Bresciano

Dr. Brian Fitzpatrick

EPA COUNCILPRESIDENT

Dr. Khee Hian Phoa

PRESIDENT ELECTProf. Phophi Kamposiora

IMMEDIATE PAST PRESIDENTProf. Guillermo Pradies

HONORARY SECRETARY Prof. Mutlu Özcan

HONORARY TREASURER Prof. George Papavasiliou

Dr. Ransom Altman

HONORARY WEB EDITOR Prof. Suresh Nayar

PAST PRESIDENTSProf. Norina Forna

Prof. Juergen Setz

Prof. Hana Hubalkova

Prof. Cetin Sevuk

ELECTED COUNCIL MEMBERS

Dr. Rafael Martinez de Fuentes

Prof. Mehmet Ali Kilicarslan

PROMOTION/MARKETING COMMITTEEProf. Timo Närhi

EPA SPECIALISATION COMMITTEE

Dr. Khee Hian Phoa5

INTERNATIONAL CONFERENCES

Japan 2007, 1991

Italy 2013

Hawaii2011

South Africa 2009

Greece 2005

Australia 2001

Malta 1997

Canada 2003, 1989

South Korea 2015

Mainland USA 1995, 1985

The Netherlands 2019

Sweden 1999

Switzerland 1993, 1987

Chile2017

SPONSORS & EXHIBITORS

Global Partner Nobel Biocare Quintessence Publishing

Silver Exhibitors Ivoclar Vivadent, Shanghai Rebone Biomaterials

Exhibitor Navident

Sponsors as of January 2019, please visit the conference website for current sponsors.

* Additional corporate supporters are encouraged to join us in Amsterdam to presentthe latest products and services.

Page 6: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

Invited SpeakersWael Att

Professor, Chairman Dept. of Prosthodontics Tufts University School of Dental Medicine Freiburg, Germany

Limor Avivi-Arber

University of Toronto Prosthodontics Faculty of Dentistry Assistant Professor Dept. of Prosthodontics Toronto, ON, Canada

Izchak Barzilay*

Prosthodontics and Restorative Dentistry Mt. Sinai Hospital Toronto, ON, Canada

Ho Beom Kwon

Republic of Korea

Markus Blatz*

University of Pennsylvania School of Dental Medicine Dept. of Preventive & Restorative Sciences Philadelphia, PA USA

Lawrence Brecht*

Institute of Reconstructive Plastic Surgery New York University-Langone Medical Center Jonathan & Maxine Ferencz Advanced Education New York, NY, USA

Hugo de Bruyn*

Professor Periodontology & Oral Impantology Ghent University Groningen, the Netherlands

Robert Carmichael*

Holland Bloorview Kids Rehabilitation Hospital Faculty of Dentistry Toronto, ON, Canada

David Chvartszaid

Graduate Program Director, Prosthodontics Assistant Professor, Faculty of Dentistry University of Toronto Toronto,ON, Canada

Joke Duyck*

Professor, Dept. of Oral Health Sciences KU Leuven Flanders, Belgium

Daniel Edelhoff*

Director and Chair Dept. of Prosthetic Dentistry University Hospital Munich, Germany

Egon Euwe

Periodontics Implant Dentistry

Alberto Fonzaer

Univerity of Triest and Modena Italian Academy of Prosthetic Dentistry Campoformido, Italy

David Gratton

Associate Professor Maxillofacial Prosthodontics

Bassam Hassan

Prosthodontist Acibadem International Medical Center Amsterdam, the Netherlands

Egusa Hiroshi*

Professor, Chair Division of Molecular & Regenerative Prosthodontics Tohoku University Sendai, Japan

Dale Howes

University of Witwatersrand Dept. of Oral Rehabilitation Professor (Adj) Johannesburg, South Africa

Xinquan Jiang

Ninth Peoples Hospital Shanghai JiaoTong University School of Medicine Shanghai, China

Yasuhiro Kawai*

Professor Nihon University Japan

Matthias Kern

Christian-Albrechts University at Kiel Germany

6

Thomas Salinas*

Mayo Clinic Department of Dental Specialties Rochester, MN, USA

Ami Smidt

The Hebrew Univ.- Hadassah, Faculty of Dentistry Head Center for Graduate Studies Prosthodontics Dept. of Prosth.Tel-Aviv Israel

Sayaka Tada

National Unversity of Singapore Singapore

Bart Van Meerbeek

Co-Editor-in-Chief Journal of Adhesive Dentistry Belgium

Sandy van Teeseling

Private Orthodontic Practice University Medical Centre Groningen Haarlem, the Netherlands

Anita Visser

Maxillofacial Prosthodontist University Medical Center Groningen Groningen, the Netherlands

Terry Walton*

Professor Affiliate in Clinical Dentistry University of Sydney Sydney, Australia

Daniel Wismeijer

ACTA (Dental Faculty Free University of Amsterdam) Dept. of Implantology & Fixed Prosthodontics Amsterdam, the Netherlands

Christopher Wyatt*

Professor, Chair Division of Prosthodontics & Dental Geriatrics Faculty of Dentistry University of British Columbia

*Keynote speaker

Jongyub Kim

Boston SMart Dental Private Practice Seoul, Korea

Sreenivas Koka

Koka Dental Clinic Loma Linda University UCLA (Advanced Prosthodontics) San Diego, CA, USA

Frank Lobbezoo

TMD/Orofacial Pain President of the Dutch Dental Society (NTG)

Leonardo Marchini

Assistant Professor Dept. of Preventive and Community Dentistry University of Iowa College of Dentistry Iowa City, IA, USA

Richard van Merkesteyn*

Head of Dept. Oral & Maxillofacial Surgery Leiden, the Netherlands

Brian Millar*

Professor Blended Learning in Dentistry at Kings College London United Kingdom

Ken Nicholson

Managing Director ProfiVision Limited (T/A SmileTube.tv) Belfast, United Kingdom

Carlo Poggio*

Professor, Specialist in Prosthodontics and Periodontics Chairman and Program Director Prosthodontics

Khee Hian Phoa

MaxilloFacial Prosthodontist Restorative Dentist Leiden University Medical CenterKleinrijk Rotterdam, the Netherlands

Harry Reinstema

Maxillofacial Prosthodontist University Medical Center Dept. Oral Maxillofacial Surgery Groningen, the Netherlands

Invited speakers subject to change. Please visit the ICP/EPA Conference website for the latest information: www.icp-conference.com

Page 7: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

7

Abstracts and PostersCALL FOR PAPERS– You must be an active member of the ICP/EPA to submit abstract papers (poster). If you are not current with annual

dues or have not yet joined the ICP/EPA, please do so before submitting an abstract.

– All posters relating to conference topics will be accepted.

– Abstract papers must be submitted on the ICP/EPA website: www.icp-conference.com > Call for Papers

Instructions for oral and poster presentations are posted on the ICP/EPA conference website. Please keep your abstracts to 350 words or less. All selected abstracts will be published in our conference program book. Papers will be published as presented by author. Please be sure to proofread your paper. Abstracts may be edited on the conference website up to June 15, 2019 (printing deadline).

DEADLINES

5/31/19 Oral Abstract Submission

5/31/19 Graduate Student Abstract Papers

6/14/19 Poster Abstract Submission

6/19/19 Oral Abstract Notifications

POSTER AWARDSAwards will be presented to outstanding posters during the ICP/EPA meeting.

Eligibility: First (presenting) author of any poster presented at the meeting will be eligible for the prize.

Adjudication: A panel of judges will review the posters.

Presentation: The awards will be presented during the ICP/EPA meeting.

Prize: here will be prizes for posters in four categories. Due to the large number of posters submitted, poster abstract papers will be reviewed upon submission and nominations for awards will first be selected based on the quality of the submitted abstract. Please prepare your abstract paper accordingly. However, all posters will be reviewed to determine if additional nominations are acceptable for awards.

PRIZES1. The best case presentation poster2. The best posters depicting clinical research3. The best posters for all other research4. The best posters in any category from local participants

Publication: Abstracts with definitive scientific data may be considered for publication in the IJP.

Attendance: The poster’s “first author” must be the “presenter” during the scheduled poster session. Presenters who fail to attend the meeting will have their abstract removed from publication and consideration for awards.

Views expressed by the presenters at the ICP/EPA Meeting are solely their own and do not necessarily reflect the positions or policies of the ICP/

EPA. The ICP/EPA reserves the right to cancel or modify its program as circumstances might dictate.

Page 8: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

8

Social Events

FRIDAY, SEPTEMBER 6, 201919:30 - 22:30 ICP/EPA Reception and Banquet*

Cost: $150 per person ($175 after 8/31/19)

Delegates and guests are invited to attend this gala event for the recognition of participating countries and their representatives, presentation of awards and installation of new officers. Reception, light appetizers, wine, dinner and entertainment are included in this banquet event.

*Reservations Required

SATURDAY, SEPTEMBER 7, 201915:00 - 19:30 ICP/EPA Networking Outing* Canal Tour and Dinner

Cost: $125 per person

Join your colleagues for a post conference outing.Besides providing a stunning backdrop to the city's historical centre, floating down Amsterdam's canals is one if the most memorable ways to discover the city's sights and attractions.

*Reservations Required

Ele

ctiv

e G

uest

Dail

y

Att

en

dee N

etw

ork

ing

Even

ts

FRIDAY, SEPTEMBER 6, 201909:00 - 13:00 Daily Spouse/Guest Amsterdam Walking Tour (including the Rijksmuseum)

Cost: $65 per person 09:00 - 13:00 Pick up at the Beurs van Berlage (meet in lobby)

A walking tour through the city center of Amsterdam. A stop will be made at the national museum of Amsterdam, “the Rijksmuseum.” This museum is world famous and here the largest collection of paintings by the Dutch old masters can be admired. Work from Frans Hals, Jan Steen and Rembrandt (the Nightwatch painting) are assembled here. For the first time, the entire collection is on display at All the Rembrandts of the Rijksmuseum.

THURSDAY, SEPTEMBER 5, 201910:00 - 12:30 Daily Spouse/Guest Tour Amsterdam Taste Tour

Cost: $60 per person 10:00 - 12:30 Pick up at the Beurs van Berlage (meet in lobby)

The guide accompanies you through a maze of Amsterdam’s many food stalls. We explain how local delicacies are made and advise on items that you might enjoy. We visit some secret eateries that are off the map so that you get to experience the sounds and smell of Amsterdam’s best dining experiences.

Note: Fee for elective tours includes: transportation, English-speaking guide, and entrance fees. Tours are based on a minimum attendance and are subject to change.

Page 9: ICP & EPA JOINT MEETING REGISTRATION BROCHURE · 2019-06-20 · Now that we, starting from 1st January 2018, take over the Co-Presidency of ICP ... These two topics suggest covering

Social Events Joint ICP/EPA Conference Registration Form

9

ALL FEES ARE IN $USD

Please register online @ www.icp-conference.com. If unable to register online, please fill out and fax form to 1-858-272-1018.To ensure registration is legible via fax, please type or print information very clearly and with large characters.

Name: First (Given Name) Last (Family Name) Title/s

Address: Tel: ( ) University/Hospital/Company Department (please include country code)

Fax: ( ) Street Address Suite #

E-mail:City State/Province Zip Code/Postal Code Country (required for payment receipt)

Early DiscountUntil Jun 30, 2019

On-site FeesAfter Sep 1, 2019

ICP Member (2+ consecutive years) $475 $625ICP New Member $575 $725ICP Student/Resident (2+ consecutive years) $250 $395

ICP New Student/Resident $275 $420EPA Member $475 $625Non Member Student/Resident* $275 $420

Dental Allied Technicians $550 $695

Non Member $675

Registration From Jun 30 -Aug 31, 2019

$575$675$350

$375$575$375

$650

$775 $825

$

Checks payable in $USD to ICP Conference Please mail check and registration form to: ICP, 4425 Cass St. Suite A, San Diego, CA 92109 USA

Visa/Master Card accepted. Card# CVV Code Exp. Date / (3 digit # on back of card) month/year

Authorized Signature Date

Registration Refund Policy: Requests must be received in writing prior to 8/1/19. Fees will be refunded less a $75

administration fee. No refunds after 8/1/19.

TOTAL FEES $

Reg

istr

ati

on

Fees

Ad

dit

ion

al

Fees

Paym

en

t

Registration fees are subject to change

*Non Member Student/Resident- must be a student in an accredited program and provide name of program director and school. Please notethat by becoming an ICP Student Member, the overall cost of membership and registration fees would be lower. Joining the ICP will alsoinclude additional benefits. Please consider ICP membership.Fees for ICP/EPA Members, Dental Allied Technicians, Non Member and Student Includes: General and Poster Sessions, Conference Lunchand Breaks, ICP/EPA Business Lunch (ICP/EPA members only), Welcome Reception, Poster Session and Exhibit Reception.

Note: To present an oral or poster presentation, delegates are encouraged to be an ICP or EPA member. All ICP and EPA members must be current with annual dues prior to registering as a member.

ADDITIONAL FEES$

$

$

$

$

Sept 5 Amsterdam Tastes Tour - $60

Sept 6 Amsterdam Walking Tour - $65

Sept 6 Reception and Banquet - $150 ($175 after 8/31/19)

Sept 7 ICP/EPA Networking Outing - $125

Accompanying Guest(s)* - $75 ($100 after 8/31/19)

Includes: Welcome Reception, Poster Session and Exhibit Reception